Li Qian, Xu Shangzhi, Chen Xi, Zhang Xu, Li Xiating, Lin Lixia, Gao Duan, Wu Meng, Yang Sen, Cao Xiyu, Tan Tianqi, Hu Wenqi, Guo Jinrong, Huang Li, Chen Renjuan, Zhou Xuezhen, Cui Wenli, Xiong Ting, Gao Qin, Wu Yuanjue, Hong Miao, Wang Xiaoyi, Zhang Guofu, Zhang Yu, Zhong Chunrong, Xiong Guoping, Yang Hongying, Yang Nianlan, Yang Xuefeng, Hao Liping, Jin Zhichun, Yang Nianhong
From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang).
The Central Hospital of Wuhan, P.R. China (G.X.).
Hypertension. 2020 Jul;76(1):150-156. doi: 10.1161/HYPERTENSIONAHA.119.14621. Epub 2020 May 11.
Current results regarding the effect of folic acid (FA) supplement use on gestational hypertension (GH) and preeclampsia are limited and inconsistent. We aimed to investigate whether FA supplement use was associated with GH and preeclampsia. Participants from the Tongji Maternal and Child Health Cohort with information on periconceptional FA supplement use and diagnosis of GH/preeclampsia were included (n=4853). Robust Poisson regression was used to assess the association of FA supplement use and GH and preeclampsia. Among the 4853 participants in this study, 1161 (23.9%) and 161 (3.3%) women were diagnosed with GH and preeclampsia, respectively. The risk ratio of developing GH was higher in women who used ≥800 µg/d FA supplement from prepregnancy through midpregnancy than nonusers (risk ratio, 1.33 [1.08-1.65]). After adjusting for social-demographic, reproductive, lifestyle factors, family history of hypertension, other supplement use, and gestational weight gain, the adverse association remained significant (risk ratio, 1.32 [1.06-1.64]). Restricting the analysis among women with normal weight, without family history of hypertension, and without gestational diabetes mellitus, the positive FA-GH association still existed. We did not find any significant association between FA supplement use and preeclampsia regardless of adjustment. High-dose (≥800 µg/d) FA supplement use from prepregnancy through midpregnancy was associated with increased risk of GH. Attention should be given to avoid the potential risk of GH due to inappropriate FA supplement use in women who are planning or capable of pregnancy.
目前关于叶酸（FA）补充剂使用对妊娠期高血压（GH）和子痫前期影响的研究结果有限且不一致。我们旨在调查FA补充剂的使用是否与GH和子痫前期有关。纳入了来自同济妇幼队列研究的参与者，这些参与者有孕前FA补充剂使用情况以及GH/子痫前期诊断的相关信息（n = 4853）。采用稳健泊松回归来评估FA补充剂使用与GH和子痫前期之间的关联。在本研究的4853名参与者中，分别有1161名（23.9%）和161名（3.3%）女性被诊断为GH和子痫前期。从孕前到孕中期使用≥800μg/d FA补充剂的女性发生GH的风险比未使用者更高（风险比，1.33[1.08 - 1.65]）。在调整了社会人口统计学、生殖、生活方式因素、高血压家族史、其他补充剂使用情况以及孕期体重增加后，这种不良关联仍然显著（风险比，1.32[1.06 - 1.64]）。在体重正常、无高血压家族史且无妊娠期糖尿病的女性中进行分析，FA与GH之间的正向关联仍然存在。无论是否进行调整，我们均未发现FA补充剂使用与子痫前期之间存在任何显著关联。从孕前到孕中期使用高剂量（≥800μg/d）FA补充剂与GH风险增加有关。对于计划怀孕或有怀孕能力的女性，应注意避免因不适当使用FA补充剂而导致GH的潜在风险。
