Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, South Korea.
Biostatistical Consulting Unit, Soonchunhyang University Medical Center, Seoul, South Korea.
PLoS One. 2014 May 19;9(5):e97273. doi: 10.1371/journal.pone.0097273. eCollection 2014.
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.
尽管有越来越多的证据表明叶酸除了预防神经管缺陷之外，对其他不良妊娠结局也有额外的保护作用，但这些作用尚未详细阐明。我们评估了补充叶酸是否与良好的母婴结局相关。这是对我们之前研究中 215 名孕妇的二次分析。通过电话访谈补充了关于产前叶酸补充的额外数据，对现有的人口统计学、产妇和胎儿数据进行了统计学分析。叶酸补充后母体血液中的叶酸浓度明显升高（24.6ng/mL 比 11.8ng/mL）。相比之下，叶酸补充后母体血液中的同型半胱氨酸水平降低（5.5µmol/mL 比 6.8µmol/mL）。子痫前期的发生率（比值比[OR]，0.27；95%置信区间[CI]，0.09-0.76）和胎儿生长受限（SGA；9.2%比 20.0%；OR，0.42；95%CI，0.18-0.99）在叶酸补充组均低于对照组。其他妊娠结局与叶酸补充无关。这些发现表明，叶酸补充可能有助于预防子痫前期和 SGA。需要进一步的研究来阐明叶酸补充对妊娠结局的有利影响。
