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孕期补充叶酸对儿童癌症的保护作用:病例对照研究的系统评价和荟萃分析

The Protective Effect of Maternal Folic Acid Supplementation on Childhood Cancer: A Systematic Review and Meta-analysis of Case-control Studies.

作者信息

Wan Ismail Wan Rosmawati, Abdul Rahman Raudah, Rahman Nur Ashiqin Abd, Atil Azman, Nawi Azmawati Mohammed

机构信息

Department of Community Health, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.

Department of Community Health, Faculty of Medicine, University Malaysia Sabah, Kota Kinabalu, Malaysia.

出版信息

J Prev Med Public Health. 2019 Jul;52(4):205-213. doi: 10.3961/jpmph.19.020. Epub 2019 Jul 2.

Abstract

OBJECTIVES

Maternal folic acid supplementation is considered mandatory in almost every country in the world to prevent congenital malformations. However, little is known about the association of maternal folic acid intake with the occurrence of childhood cancer. Hence, this study aimed to determine the effects of maternal folic acid consumption on the risk of childhood cancer.

METHODS

A total of 158 related articles were obtained from PubMed, Google Scholar, Scopus, and ProQuest using standardized keywords, of which 17 were included in the final review.

RESULTS

Eleven of the 17 articles showed a significant protective association between maternal folic acid supplementation and childhood cancer. Using a random-effects model, pooled odds ratios (ORs) showed a protective association between maternal folic acid supplementation and childhood acute lymphoblastic leukaemia (OR, 0.75; 95% confidence interval [CI], 0.66 to 0.86). However, there was no significant association between maternal folic acid supplementation and acute myeloid leukaemia (OR, 0.70; 95% CI, 0.46 to 1.06) or childhood brain tumours (OR, 1.02; 95% CI, 0.88 to 1.19).

CONCLUSIONS

Maternal folic acid supplementation was found to have a protective effect against childhood acute lymphoblastic leukaemia. Thus, healthcare professionals are recommended to provide regular health education and health promotion to the community on the benefits of folic acid supplementation during pregnancy.

摘要

目的

世界上几乎每个国家都认为孕妇补充叶酸是预防先天性畸形的必要措施。然而,关于孕妇叶酸摄入量与儿童癌症发生之间的关联却知之甚少。因此,本研究旨在确定孕妇摄入叶酸对儿童癌症风险的影响。

方法

使用标准化关键词从PubMed、谷歌学术、Scopus和ProQuest共获取158篇相关文章,其中17篇纳入最终综述。

结果

17篇文章中有11篇显示孕妇补充叶酸与儿童癌症之间存在显著的保护关联。采用随机效应模型,合并比值比(OR)显示孕妇补充叶酸与儿童急性淋巴细胞白血病之间存在保护关联(OR,0.75;95%置信区间[CI],0.66至0.86)。然而,孕妇补充叶酸与急性髓细胞白血病(OR,0.70;95%CI,0.46至1.06)或儿童脑肿瘤(OR,1.02;95%CI,0.88至1.19)之间无显著关联。

结论

发现孕妇补充叶酸对儿童急性淋巴细胞白血病有保护作用。因此,建议医护人员向社区定期开展关于孕期补充叶酸益处的健康教育和健康促进活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a2c/6686110/d6969c14b194/jpmph-52-4-205f1.jpg

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