叶酸补充剂与膳食叶酸摄入量及子痫前期风险
Folic acid supplementation and dietary folate intake, and risk of preeclampsia.
作者信息
Wang Y, Zhao N, Qiu J, He X, Zhou M, Cui H, Lv L, Lin X, Zhang C, Zhang H, Xu R, Zhu D, Dang Y, Han X, Zhang H, Bai H, Chen Y, Tang Z, Lin R, Yao T, Su J, Xu X, Liu X, Wang W, Ma B, Liu S, Qiu W, Huang H, Liang J, Wang S, Ehrenkranz R A, Kim C, Liu Q, Zhang Y
机构信息
Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China.
Department of Environmental Health Sciences, School of Public Health, Yale University, New Haven, CT, USA.
出版信息
Eur J Clin Nutr. 2015 Oct;69(10):1145-1150. doi: 10.1038/ejcn.2014.295. Epub 2015 Jan 28.
BACKGROUND/OBJECTIVES: Folic acid supplementation has been suggested to reduce the risk of preeclampsia. However, results from few epidemiologic studies have been inconclusive. We investigated the hypothesis that folic acid supplementation and dietary folate intake before conception and during pregnancy reduce the risk of preeclampsia.
SUBJECTS/METHODS: A birth cohort study was conducted in 2010-2012 at the Gansu Provincial Maternity & Child Care Hospital in Lanzhou, China. A total of 10,041 pregnant women without chronic hypertension or gestational hypertension were enrolled.
RESULTS
Compared with nonusers, folic acid supplement users had a reduced risk of preeclampsia (OR=0.61, 95% CI: 0.43-0.87). A significant dose-response of duration of use was observed among women who used folic acid supplemention during pregnancy only (P-trend=0.007). The reduced risk associated with folic acid supplement was similar for mild or severe preeclampsia and for early- or late-onset preeclampsia, although the statistical significant associations were only observed for mild (OR=0.50, 95% CI: 0.30-0.81) and late-onset (OR=0.60, 95% CI: 0.42-0.86) preeclampsia. The reduced risk associated with dietary folate intake during pregnancy was only seen for severe preeclampsia (OR=0.52, 95% CI: 0.31-0.87, for the highest quartile of dietary folate intake compared with the lowest).
CONCLUSIONS
Our study results suggest that folic acid supplementation and higher dietary folate intake during pregnancy reduce the risk of preeclampsia. Future studies are needed to confirm the associations.
背景/目的：已有研究表明补充叶酸可降低先兆子痫的风险。然而，少数流行病学研究的结果尚无定论。我们调查了孕前及孕期补充叶酸和膳食叶酸摄入量可降低先兆子痫风险这一假设。
对象/方法：2010年至2012年在中国兰州的甘肃省妇幼保健院进行了一项出生队列研究。共纳入10041名无慢性高血压或妊娠期高血压的孕妇。
结果
与未使用者相比，叶酸补充剂使用者患先兆子痫的风险降低（OR = 0.61，95%CI：0.43 - 0.87）。仅在孕期使用叶酸补充剂的女性中观察到使用持续时间的显著剂量反应（P趋势 = 0.007）。叶酸补充剂相关的风险降低在轻度或重度先兆子痫以及早发型或晚发型先兆子痫中相似，尽管仅在轻度（OR = 0.50，95%CI：0.30 - 0.81）和晚发型（OR = 0.60，95%CI：0.42 - 0.86）先兆子痫中观察到统计学显著关联。孕期膳食叶酸摄入量相关的风险降低仅在重度先兆子痫中可见（与最低膳食叶酸摄入量四分位数相比，最高四分位数的OR = 0.52，95%CI：0.31 - 0.87）。
结论
我们的研究结果表明，孕期补充叶酸和增加膳食叶酸摄入量可降低先兆子痫的风险。需要进一步研究来证实这些关联。
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