CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
Department of Public Health, History of Medicine and Gynecology, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Universidad Miguel Hernández, Ctra. Nacional 332 S/n, Sant Joan D'alacant, 03550, Alicante, Spain.
Eur J Nutr. 2019 Feb;58(1):241-251. doi: 10.1007/s00394-017-1588-7. Epub 2017 Nov 27.
We investigated the association between maternal use of folic acid (FA) during pregnancy and child anthropometric measures at birth.
We included 2302 mother-child pairs from a population-based birth cohort in Spain (INMA Project). FA dosages at first and third trimester of pregnancy were assessed using a specific battery questionnaire and were categorized in non-user, < 1000, 1000-4999, and ≥ 5000 µg/day. Anthropometric measures at birth (weight in grams, length and head circumference in centimetres) were obtained from medical records. Small for gestational age according to weight (SGA-w), length (SGA-l) and head circumference (SGA-hc) were defined using the 10th percentile based on Spanish standardized growth reference charts. Multiple linear and logistic regression analyses were used to explore the association between FA dosages in different stages of pregnancy and child anthropometric measures at birth.
In the multiple linear regression analysis, we found a tendency for a negative association between the use of high dosages of FA (≥ 5000 µg/day) in the periconceptional period of pregnancy and weight at birth compared to mothers who were non-users of FA (β = - 73.83; 95% CI - 151.71, 4.06). In the multiple logistic regression, a greater risk of SGA-w was also evident among children whose mothers took FA dosages of 1000-4999 (OR = 2.21; 95% CI 1.17, 4.19) and of ≥ 5000 µg/day (OR = 2.32; 95% CI 1.06, 5.08) compared to mothers non-users of FA in the periconceptional period of pregnancy.
Our findings suggest that a high dosage of FA (≥ 1000 µg/day) may be associated with an increased risk of SGA-w at birth.
我们研究了孕妇在妊娠期间叶酸（FA）的使用与儿童出生时的人体测量指标之间的关联。
我们纳入了西班牙一项基于人群的出生队列中的 2302 对母婴对（INMA 项目）。使用特定的电池问卷评估妊娠第一和第三阶段的 FA 剂量，并将其分为非使用者、<1000μg/天、1000-4999μg/天和≥5000μg/天。出生时的人体测量指标（克重、厘米长和厘米头围）从病历中获得。根据西班牙标准化生长参考图表，基于第 10 百分位定义了体重（SGA-w）、长度（SGA-l）和头围（SGA-hc）小于胎龄儿。采用多元线性和逻辑回归分析探讨妊娠不同阶段 FA 剂量与儿童出生时人体测量指标之间的关系。
在多元线性回归分析中，我们发现与非 FA 使用者相比，妊娠前叶酸高剂量（≥5000μg/天）使用者出生时体重有负向关联的趋势（β=-73.83；95%置信区间-151.71，4.06）。在多元逻辑回归中，母亲在妊娠前阶段使用 FA 剂量为 1000-4999μg/天（OR=2.21；95%置信区间 1.17，4.19）和≥5000μg/天（OR=2.32；95%置信区间 1.06，5.08）时，SGA-w 的风险也明显增加，与非 FA 使用者相比。
我们的研究结果表明，高剂量的 FA（≥1000μg/天）可能与出生时 SGA-w 的风险增加有关。
