Departamento de Salud Pública, Campus San Juan, Universidad Miguel Hernández, Carretera de Valencia s/n, San Juan de Alicante, Spain.
Br J Nutr. 2011 May;105(9):1352-60. doi: 10.1017/S0007114510005143. Epub 2011 Jan 28.
We examined the relationship between dietary folate intake and periconceptional use of folic acid (FA) supplements, and small-for-gestational age for weight (SGA-W) and height (SGA-H). The study is based on 786 Spanish women aged 16 years or above, who attended the first-term prenatal population-based screening programme (10-13 weeks) at the reference hospital 'La Fe', Valencia, with singleton pregnancy. Periconceptional use of FA supplements was categorised as non-users, moderate users ( ≤ 1 mg/d) and high users (>1 mg/d). Babies born to mothers who used high doses of FA supplements had a significant reduction in mean birth height compared with babies of non-users (β = - 0·53, 95 % CI - 0·96, - 0·09). As regards weight, mothers using moderate and high doses of FA supplements had lower-birth-weight babies for gestational age than non-users (β = - 22·96, 95 % CI - 101·14, 55·23; β = - 89·72, 95 % CI - 188·64, 9·21, respectively), although these decreases were not significant. Results from the multivariate logistic regression models showed that high FA supplement users had a higher significant risk for SGA-H (OR 5·33, 95 % CI 2·08, 13·7), and that users of moderate doses were not associated with a higher risk of either a SGA-W or a SGA-H baby. In contrast, increased quintiles of the dietary intake of folate were associated with a decreased risk of SGA-W (P for trend = 0·002), although no association was observed for SGA-H. Our findings suggest that periconceptional use of FA supplements greater than 1 mg/d is associated with decreased birth height and may entail a risk of decreased birth weight.
我们研究了叶酸摄入与围孕期叶酸补充剂使用及胎儿小于胎龄(SGA-W)和身高(SGA-H)的关系。本研究基于 786 名年龄在 16 岁及以上的西班牙妇女,这些妇女均在瓦伦西亚“La Fe”参考医院参加了基于人群的第一次产前筛查项目(10-13 周),且怀有单胎妊娠。围孕期叶酸补充剂使用情况分为非使用者、中剂量使用者(≤1mg/d)和高剂量使用者(>1mg/d)。与非使用者相比,使用高剂量叶酸补充剂的母亲所生婴儿的平均出生身高显著降低(β=-0.53,95%CI-0.96,-0.09)。至于体重,使用中剂量和高剂量叶酸补充剂的母亲所生婴儿的出生体重比非使用者的低(β=-22.96,95%CI-101.14,55.23;β=-89.72,95%CI-188.64,9.21),尽管这些差异没有统计学意义。多变量逻辑回归模型的结果显示,高剂量叶酸补充剂使用者发生 SGA-H 的风险显著增加(OR 5.33,95%CI 2.08,13.7),而中剂量使用者与 SGA-W 或 SGA-H 婴儿的发生风险增加无关。相反,叶酸膳食摄入量较高的五分位数与 SGA-W 的风险降低相关(趋势 P=0.002),而 SGA-H 则无此关联。我们的研究结果表明,每天使用超过 1mg 的叶酸补充剂与出生身高降低相关,可能会降低出生体重。