Wen Shi Wu, Guo Yanfang, Rodger Marc, White Ruth Rennicks, Yang Qiuying, Smith Graeme N, Perkins Sherry L, Walker Mark C
OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada.
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
PLoS One. 2016 Feb 22;11(2):e0149818. doi: 10.1371/journal.pone.0149818. eCollection 2016.
This prospective cohort study designed to assess the effect of folic acid supplementation in pregnancy on the risk of preeclampsia (PE) took place in Ottawa, ON and Kingston, ON, Canada, from September 1, 2002 to August 31, 2008. Pregnant women, less than 20 weeks gestational age were recruited and delivered in the Ottawa region and the Kingston General Hospital. Demographic characteristics of the study participants and the patterns of supplementation of folic acid were described and occurrence of PE between women with folic acid supplementation during pregnancy and women without were compared. Multiple logistic regression was used in the estimation of the independent effect of supplementation of folic acid. Additional analyses assessing the effect of low RBC and serum folate and dose-response relationship were performed. Analyses were performed in all study participants, and then in high risk and low risk sub-groups, respectively. A total of 7,669 participants were included in the final analysis. Ninety five percent of the study participants were taking folic acid supplementation in early second trimester. The rate of PE was lower in the supplementation group than in the no supplementation group, and the difference was statistically significant in high risk women. Similar patterns of associations were observed in analysis by RBC and serum folate levels and in dose-response analysis. Folic acid supplementation in pregnancy may reduce PE risk in pregnant women, especially in those women with increased risk of developing PE.
这项前瞻性队列研究旨在评估孕期补充叶酸对先兆子痫（PE）风险的影响，于2002年9月1日至2008年8月31日在加拿大安大略省渥太华市和金斯敦市进行。招募了妊娠龄小于20周的孕妇，她们在渥太华地区和金斯敦综合医院分娩。描述了研究参与者的人口统计学特征和叶酸补充模式，并比较了孕期补充叶酸的妇女和未补充叶酸的妇女中PE的发生情况。采用多因素逻辑回归来估计补充叶酸的独立作用。还进行了评估低红细胞和血清叶酸水平的影响以及剂量反应关系的额外分析。分析在所有研究参与者中进行，然后分别在高危和低危亚组中进行。最终分析共纳入7669名参与者。95%的研究参与者在孕中期早期服用叶酸补充剂。补充组的PE发生率低于未补充组，且在高危女性中差异具有统计学意义。在按红细胞和血清叶酸水平进行的分析以及剂量反应分析中观察到类似的关联模式。孕期补充叶酸可能会降低孕妇患PE的风险，尤其是那些发生PE风险增加的女性。
