Liu Cheng, Liu Chongdong, Wang Qiushi, Zhang Zhenyu
Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 North Road of Workers Stadium, Chaoyang District, Beijing, 100020, China.
Arch Gynecol Obstet. 2018 Oct;298(4):697-704. doi: 10.1007/s00404-018-4823-4. Epub 2018 Jul 5.
We aimed to systematically assess the relationship between folic acid supplementation in pregnancy and risk of preeclampsia and gestational hypertension.
The relevant studies were included by retrieving the Embase, PubMed and Cochrane library databases. Data extraction was conducted by two investigators independently. The risk ratio (RR) and 95% confidence interval (CI) were used as effect indexes to evaluate the relationship between folic acid supplementation and risk of gestational hypertension or preeclampsia. A subgroup analysis was performed according to the supplementation patterns of folic acid. The homogeneity of the effect size was tested across the studies, and publication biases were examined.
In total, 13 cohort studies and 1 randomized controlled trial study was included, containing 160,562 and 149,320 women with and without folic acid supplementation during pregnancy. Pooled results showed that risk of gestational hypertension was not associated with the supplementation of folic acid. However, folic acid supplementation during pregnancy could significantly reduce the risk of preeclampsia. Moreover, the results of subgroup analysis showed that the decreased preeclampsia risk was associated with supplementation of multivitamins containing folic acid rather than folic acid alone.
Our findings indicate that the supplementation of multivitamins containing folic acid during pregnancy could significantly lower preeclampsia risk.
我们旨在系统评估孕期补充叶酸与子痫前期及妊娠期高血压风险之间的关系。
通过检索Embase、PubMed和Cochrane图书馆数据库纳入相关研究。由两名研究者独立进行数据提取。采用风险比（RR）和95%置信区间（CI）作为效应指标，评估补充叶酸与妊娠期高血压或子痫前期风险之间的关系。根据叶酸补充模式进行亚组分析。对各研究的效应大小进行同质性检验，并检查发表偏倚。
共纳入13项队列研究和1项随机对照试验研究，分别包含160562名孕期补充叶酸和149320名未补充叶酸的女性。汇总结果显示，妊娠期高血压风险与补充叶酸无关。然而，孕期补充叶酸可显著降低子痫前期风险。此外，亚组分析结果表明，子痫前期风险降低与补充含叶酸的多种维生素有关，而非单独补充叶酸。
我们的研究结果表明，孕期补充含叶酸的多种维生素可显著降低子痫前期风险。
