Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing, China.
Hypertension. 2013 Apr;61(4):873-9. doi: 10.1161/HYPERTENSIONAHA.111.00230. Epub 2013 Feb 11.
Emerging evidence has suggested that folic acid-containing multivitamins may markedly reduce the risk of gestational hypertension or preeclampsia. We examined whether maternal supplementation with folic acid alone during early pregnancy can prevent the occurrence of gestational hypertension and preeclampsia. The data are from a large population-based cohort study established to evaluate the effectiveness of the campaign to prevent neural tube defects with folic acid supplementation in China. We selected participants who were registered in 2 southern provinces, had exact information on folic acid use, and were not affected by chronic hypertension or diabetes mellitus before 20 weeks gestation. A logistic regression model was used to adjust for the effects of the main potential confounders, including age, body mass index, education, occupation, parity, and multiple births. The study size had 99.9% power (α=0.05) to detect a decrease of 10% over the unexposed rate of 9.4% for gestational hypertension. Among the 193 554 women (47.9% took folic acid, 52.1% did not), the overall incidence of gestational hypertension and preeclampsia was 9.5% and 2.5%, respectively. The incidence of gestational hypertension and preeclampsia was 9.7% and 2.5% for women who took folic acid, and 9.4% and 2.4% for women who did not use it. The adjusted risk ratio associated with folic acid use was 1.08 (95% confidence interval, 1.04-1.11) for gestational hypertension and 1.11 (95% confidence interval, 1.04-1.18) for preeclampsia. Our findings suggest that daily consumption of 400 μg folic acid alone during early pregnancy cannot prevent the occurrence of gestational hypertension and preeclampsia.
新的证据表明，含叶酸的多种维生素可能显著降低妊娠高血压或子痫前期的风险。我们研究了母亲在妊娠早期单独补充叶酸是否可以预防妊娠高血压和子痫前期的发生。这些数据来自于一项大型基于人群的队列研究，旨在评估中国叶酸补充预防神经管缺陷运动的效果。我们选择了在 2 个南方省份注册、叶酸使用信息确切且在妊娠 20 周前未受慢性高血压或糖尿病影响的参与者。采用逻辑回归模型调整主要潜在混杂因素的影响，包括年龄、体重指数、教育、职业、产次和多胎妊娠。该研究规模有 99.9%的效能（α=0.05），可以检测到未暴露组的妊娠高血压发生率从 9.4%下降 10%。在 193554 名妇女（47.9%服用叶酸，52.1%未服用）中，妊娠高血压和子痫前期的总发生率分别为 9.5%和 2.5%。服用叶酸的妇女妊娠高血压和子痫前期的发生率分别为 9.7%和 2.5%，未服用叶酸的妇女发生率分别为 9.4%和 2.4%。与叶酸使用相关的调整风险比为 1.08（95%置信区间，1.04-1.11），用于妊娠高血压，1.11（95%置信区间，1.04-1.18）用于子痫前期。我们的研究结果表明，妊娠早期每天单独摄入 400μg 叶酸不能预防妊娠高血压和子痫前期的发生。
