Comparison of high dose and low dose folic acid supplementation on prevalence, onset and severity of preeclampsia

Abstract

Background:Folic acid supplementation had previously mentioned as a protective factor against the onset of preeclampsia (PE). In this study, we aimed to compare the effect of high dose (5 mg daily) and low dose (1 mg daily) of folic acid supplementation on prevalence, onset and severity of PE.Materials and Methods:Pregnant women who were in the first trimester and referred to prenatal care university hospitals of Isfahan, Iran during October 2013–May 2015 were included in this study, then they were randomly divided into two groups of 5 mg and 1 mg (treated with daily 5 mg and 1 mg of folic acid, respectively), both groups received folic acid from the first trimester of pregnancy to 42 days after termination. Blood pressure, body mass index (BMI), and some urine and blood biochemistry parameters were measured. SPSS-22 used for statistical analysis.Results:A total of 943 pregnant women participated in the study (450 women in 1 mg group and 450 women in 5 mg group). Incidence rate of PE was 3.8% in 1 mg group and 2.4% in 5 mg group. In a comparison of preeclamptic patients in 1 mg and 5 mg group, no significant differences were seen regarding age, BMI, laboratory data, the severity of the disease, and onset (early or late) (P > 0.05).Conclusion:Although our findings support that administration of high dose folic acid may decrease the prevalence of PE, there is not enough data to support that higher amount of folic acid administration can reduce the severity of presentation's signs or ameliorate the laboratory data and the onset of PE.

Effect of high dose folic acid supplementation in pregnancy on pre-eclampsia (FACT): double blind, phase III, randomised controlled, international, multicentre trial

“…Supplementation with high dose folic acid (usually 4.0-5.0 mg daily) in pregnant women has already become widespread beyond the first trimester. 9 13 14 25 26 27 28 29 Anecdotal evidence suggests that supplementation with high dose folic acid is occurring outside the recommendations for use only in early pregnancy for prevention of neural tube defects, even though the most recent Cochrane review of folic acid in pregnancy for maternal health outcomes was not able to report on pre-eclampsia owing to lack of data from clinical trials. 30 Caution should always be exercised in recommending treatments before thorough evaluation has been completed, including follow-up of offspring when possible.…”

Preventive effects of folic acid on Zika virus-associated poor pregnancy outcomes in immunocompromised mice

“…A high dose of FA up to 5 mg/day has been proven safe in healthy women [51]; however, the beneficial effect of a high FA dose remains controversial. In preeclamptic pregnant women, daily supplementation with 1 and 5 mg FA does not significantly differ in affecting disease outcomes [52]. Importantly, in the presence of vitamin B12 deficiency, � 5 mg of FA intake may lead to adverse clinical presentations including anemia and cognitive impairment [53].…”