Preventive Effects of Folic Acid Supplementation on Adverse Maternal and Fetal Outcomes

Abstract

Although there is accumulating evidence regarding the additional protective effect of folic acid against adverse pregnancy outcomes other than neural tube defects, these effects have not been elucidated in detail. We evaluated whether folic acid supplementation is associated with favorable maternal and fetal outcomes. This was a secondary analysis of 215 pregnant women who were enrolled in our prior study. With additional data from telephone interviews regarding prenatal folic acid supplementation, existing demographic, maternal and fetal data were statistically analyzed. The concentration of folic acid in maternal blood was significantly higher following folic acid supplementation (24.6 ng/mL vs.11.8 ng/mL). In contrast, homocysteine level in maternal blood decreased with folic acid supplementation (5.5 µmol/mL vs. 6.8 µmol/mL). The rates of both preeclampsia (odds ratio [OR], 0.27; 95% confidence interval [CI], 0.09–0.76) and small for gestational age (SGA; 9.2% vs. 20.0%; OR, 0.42; 95% CI, 0.18–0.99) were lower in the folic acid supplementation group than those in the control group. Other pregnancy outcomes had no association with folic acid supplementation. The findings indicate that folic acid supplementation may help to prevent preeclampsia and SGA. Further studies are warranted to elucidate the favorable effects of folic acid supplementation on pregnancy outcomes.

Maternal folic acid supplementation for the prevention of preeclampsia: A systematic review and meta‐analysis

“…Random effects meta‐analysis of eight observational studies showed significantly lower odds of preeclampsia overall with folic acid supplementation in comparison to no supplementation: OR = 0.78 (95% CI 0.63, 0.98); I‐squared = 67% (moderately high heterogeneity). Figure shows a Forest Plot of the meta‐analysis of maternal folic acid supplementation on the outcome of preeclampsia.…”

“…No non‐English language studies were found for full text review. Ten studies were assessed as meeting the a priori inclusion criteria and were included in this systematic review …”

Folic Acid; Is Simple Folic Acid Effective to Replenish RBC Folate Stores Among Pakistani Femal Epatients? Small Case.

“…The folate level is shown to be a risk factor for NTDs. 16,17 Studies have shown that the proper intake of folic acid during peri-gestational period can decrease the chances of having NTDs in newborns. It has also been observed that administration of 5-MTHF is more effective than simple folic acid intake at improving folate status 23 , thus providing a protective effect in preventing neural tube defects in early pregnancy.…”

Isolated folate deficiency causing profound pancytopenia in pregnancy

“…In the majority of developed countries, folic acid supplementation (at least 400 µg) is recommended for 2–3 months prior to conception and throughout pregnancy into the postpartum period 6. This been adopted as a worldwide strategy to reduce the incidence of fetal neural tube defects (NTD) such as anencephaly, spina bifida and meningomyelocele.…”