Chen Zekun, Xing Yan, Yu Xue, Dou Yuqi, Ma Defu
School of Public Health, Peking University Health Science Center, Beijing, China.
Department of Pediatrics, Peking University Third Hospital, Beijing, China.
Front Pediatr. 2021 Jan 18;8:615406. doi: 10.3389/fped.2020.615406. eCollection 2020.
This study aimed to analyze the effect of folic acid supplements on infant and child allergic diseases through systematic review and meta-analysis. PubMed, The Cochrane Library and references of related articles published before January 1, 2020 were searched. Meta-analysis was used to explore the influence of folic acid on skin allergies (eczema, and atopic dermatitis) and respiratory allergies (asthma, wheezing, and allergic rhinitis). Data were collected from 15 studies with 244,018 individual participants from five different countries for meta-analysis. Folic acid was confirmed as a risk factor for allergic diseases in infant and child. The risk of allergic diseases dramatically increased when maternal folic acid intake <400 μg/day (RR = 1.050; 95% CI = 1.027-1.073) during pregnancy. Stratified analyses revealed that the association was significant only for respiratory allergy (RR = 1.067; 95% CI = 1.028-1.108) and pregnant women who only used folic acid supplements (RR = 1.070; 95% CI = 1.030-1.112) and that countries without folic acid fortification (RR = 1.046; 95% CI = 1.026-1.067). This study suggested that folic acid intake can be a risk factor for allergic diseases, especially respiratory tract allergies among infants and young children. Furthermore, pregnant women should pay attention to supplementation of folic acid from both folic acid supplements and fortified foods with folic acid during pregnancy.
本研究旨在通过系统评价和荟萃分析,分析叶酸补充剂对婴幼儿过敏性疾病的影响。检索了PubMed、Cochrane图书馆以及2020年1月1日前发表的相关文章的参考文献。采用荟萃分析探讨叶酸对皮肤过敏(湿疹和特应性皮炎)和呼吸道过敏(哮喘、喘息和过敏性鼻炎)的影响。从15项研究中收集数据,这些研究来自五个不同国家的244,018名个体参与者,用于荟萃分析。叶酸被确认为婴幼儿过敏性疾病的一个风险因素。孕期母亲叶酸摄入量<400μg/天时,过敏性疾病的风险显著增加(RR = 1.050;95%CI = 1.027 - 1.073)。分层分析显示,仅在呼吸道过敏(RR = 1.067;95%CI = 1.028 - 1.108)以及仅使用叶酸补充剂的孕妇(RR = 1.070;95%CI = 1.030 - 1.112)和未进行叶酸强化的国家(RR = 1.046;95%CI = 1.026 - 1.067)中,这种关联具有显著性。本研究表明,叶酸摄入可能是过敏性疾病的一个风险因素,尤其是婴幼儿的呼吸道过敏。此外,孕妇在孕期应注意从叶酸补充剂和含叶酸的强化食品中补充叶酸。