Nilsen Roy M, Vollset Stein E, Rasmussen Svein A, Ueland Per M, Daltveit Anne K
Section for Epidemiology and Medical Statistics, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway.
Am J Epidemiol. 2008 Apr 1;167(7):867-74. doi: 10.1093/aje/kwm373. Epub 2008 Jan 10.
The authors investigated a possible association of supplemental folic acid and multivitamin use with placental abruption by using data on 280,127 singleton deliveries recorded in 1999-2004 in the population-based Medical Birth Registry of Norway. Odds ratios, adjusted for maternal age, marital status, parity, smoking, pregestational diabetes, and chronic hypertension, were estimated with generalized estimating equations for logistic regression models. Use of folic acid and/or multivitamin supplements before or any time during pregnancy was reported for 36.4% of the abruptions (0.38% of deliveries) and 44.4% of the nonabruptions. Compared with no use, any supplement use was associated with a 26% risk reduction of placental abruption (adjusted odds ratio = 0.74, 95% confidence interval: 0.65, 0.84). Women who had taken folic acid alone had an adjusted odds ratio of 0.81 (95% confidence interval: 0.68, 0.98) for abruption, whereas multivitamin users had an adjusted odds ratio of 0.72 (95% confidence interval: 0.57, 0.91), relative to supplement nonusers. The strongest risk reduction was found for those who had taken both folic acid and multivitamin supplements (adjusted odds ratio = 0.68, 95% confidence interval: 0.56, 0.83). These data suggest that folic acid and other vitamin supplementation during pregnancy may be associated with reduced risk of placental abruption.
作者利用挪威基于人群的医学出生登记处1999 - 2004年记录的280,127例单胎分娩数据，研究了补充叶酸和使用多种维生素与胎盘早剥之间可能存在的关联。通过广义估计方程对逻辑回归模型进行估计，调整了产妇年龄、婚姻状况、产次、吸烟、孕前糖尿病和慢性高血压等因素后的比值比。在胎盘早剥病例（占分娩总数的0.38%）中，36.4%的产妇报告在怀孕前或孕期任何时间使用过叶酸和/或多种维生素；在无胎盘早剥病例中，这一比例为44.4%。与未使用任何补充剂相比，使用任何补充剂都与胎盘早剥风险降低26%相关（调整后的比值比 = 0.74，95%置信区间：0.65, 0.84）。单独服用叶酸的女性发生胎盘早剥的调整后比值比为0.81（95%置信区间：0.68, 0.98），而与未使用补充剂的女性相比，服用多种维生素的女性调整后的比值比为0.72（95%置信区间：0.57, 0.91）。同时服用叶酸和多种维生素补充剂的女性胎盘早剥风险降低最为显著（调整后的比值比 = 0.68，95%置信区间：0.56, 0.83）。这些数据表明，孕期补充叶酸和其他维生素可能与降低胎盘早剥风险有关。
