Shim Sang-Min, Yun Yeo-Ul, Kim Yun Sook
Department of Obstetrics and Gynecology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
Obstet Gynecol Sci. 2016 Mar;59(2):110-5. doi: 10.5468/ogs.2016.59.2.110. Epub 2016 Mar 16.
The objective of this study was to assess the effect of folic acid and multivitamin use during pregnancy on the risk of developing of hypertensive disorder of pregnancy.
Two reviewers independently determined all prospective cohort study, retrospective cohort study, large population based cohort study, retrospective secondary analysis, and double blinded, placebo-controlled, randomized clinical trial published using PubMed Medline database, KERIS (Korea Education and Research Information Service), Scopus, and the Cochrane Central Register of controlled trials comparing before conception throughout pregnancy intake oral multivitamin containing folic acid or folic acid alone. Meta-analyses were estimated with odds ratios and 95% confidence intervals (CIs) using random effect analysis according to heterogeneity of studies.
Data from six effect sizes from six studies involving 201,661 patients were enrolled. These meta-analyses showed multivitamin containing folic acid or folic acid alone was not significantly effective in reducing gestational hypertension or preeclampsia incidence (odds ratio, 0.91; 95% CI, 0.81 to 1.03) than the placebo. And the difference of effective sizes of preeclampsia and gestational hypertension according to two dependent variables, multivitamin and folic acid were not significant, respectively (point estimate, 0.66; 95% CI, 0.46 to 0.96).
These meta-analyses demonstrate multivitamin containing folic acid or folic acid alone was not significantly effective in reducing gestational hypertension or preeclampsia incidence.
本研究的目的是评估孕期使用叶酸和多种维生素对发生妊娠高血压疾病风险的影响。
两名评审员独立确定所有使用PubMed Medline数据库、KERIS(韩国教育与研究信息服务机构)、Scopus以及Cochrane对照试验中央注册库发表的前瞻性队列研究、回顾性队列研究、基于大人群的队列研究、回顾性二次分析以及双盲、安慰剂对照、随机临床试验,这些研究比较了孕前至孕期全程摄入含叶酸的多种维生素或单独摄入叶酸的情况。根据研究的异质性,使用随机效应分析以比值比和95%置信区间(CIs)进行荟萃分析。
纳入了来自6项研究的6个效应量的数据,涉及201,661名患者。这些荟萃分析表明,含叶酸的多种维生素或单独使用叶酸在降低妊娠期高血压或先兆子痫发病率方面,与安慰剂相比并无显著效果(比值比,0.91;95%置信区间,0.81至1.03)。并且,根据两个因变量(多种维生素和叶酸),先兆子痫和妊娠期高血压的效应量差异也不显著(点估计值,0.66;95%置信区间,0.46至0.96)。
这些荟萃分析表明,含叶酸的多种维生素或单独使用叶酸在降低妊娠期高血压或先兆子痫发病率方面并无显著效果。