Preconceptional folate supplementation and the risk of spontaneous preterm birth: a cohort study.

Hdl Handle:
http://hdl.handle.net/10147/189827
Title:
Preconceptional folate supplementation and the risk of spontaneous preterm birth: a cohort study.
Authors:
Bukowski, Radek; Malone, Fergal D; Porter, Flint T; Nyberg, David A; Comstock, Christine H; Hankins, Gary D V; Eddleman, Keith; Gross, Susan J; Dugoff, Lorraine; Craigo, Sabrina D; Timor-Tritsch, Ilan E; Carr, Stephen R; Wolfe, Honor M; D'Alton, Mary E
Affiliation:
Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas, United States of America. rkbukows@utmb.edu
Citation:
Preconceptional folate supplementation and the risk of spontaneous preterm birth: a cohort study. 2009, 6 (5):e1000061 PLoS Med.
Journal:
PLoS medicine
Issue Date:
5-May-2009
URI:
http://hdl.handle.net/10147/189827
DOI:
10.1371/journal.pmed.1000061
PubMed ID:
19434228
Abstract:
Low plasma folate concentrations in pregnancy are associated with preterm birth. Here we show an association between preconceptional folate supplementation and the risk of spontaneous preterm birth.; In a cohort of 34,480 low-risk singleton pregnancies enrolled in a study of aneuploidy risk, preconceptional folate supplementation was prospectively recorded in the first trimester of pregnancy. Duration of pregnancy was estimated based on first trimester ultrasound examination. Natural length of pregnancy was defined as gestational age at delivery in pregnancies with no medical or obstetrical complications that may have constituted an indication for delivery. Spontaneous preterm birth was defined as duration of pregnancy between 20 and 37 wk without those complications. The association between preconceptional folate supplementation and the risk of spontaneous preterm birth was evaluated using survival analysis. Comparing to no supplementation, preconceptional folate supplementation for 1 y or longer was associated with a 70% decrease in the risk of spontaneous preterm delivery between 20 and 28 wk (41 [0.27%] versus 4 [0.04%] spontaneous preterm births, respectively; HR 0.22, 95% confidence interval [CI] 0.08-0.61, p = 0.004) and a 50% decrease in the risk of spontaneous preterm delivery between 28 and 32 wk (58 [0.38%] versus 12 [0.18%] preterm birth, respectively; HR 0.45, 95% CI 0.24-0.83, p = 0.010). Adjustment for maternal characteristics age, race, body mass index, education, marital status, smoking, parity, and history of prior preterm birth did not have a material effect on the association between folate supplementation for 1 y or longer and spontaneous preterm birth between 20 and 28, and 28 to 32 wk (adjusted HR 0.31, 95% CI 0.11-0.90, p = 0.031 and 0.53, 0.28-0.99, p = 0.046, respectively). Preconceptional folate supplementation was not significantly associated with the risk of spontaneous preterm birth beyond 32 wk. The association between shorter duration (<1 y) of preconceptional folate supplementation and the risk of spontaneous preterm birth was not significant after adjustment for maternal characteristics. However, the risk of spontaneous preterm birth decreased with the duration of preconceptional folate supplementation (test for trend of survivor functions, p = 0.01) and was the lowest in women who used folate supplementation for 1 y or longer. There was also no significant association with other complications of pregnancy studied after adjustment for maternal characteristics.; Preconceptional folate supplementation is associated with a 50%-70% reduction in the incidence of early spontaneous preterm birth. The risk of early spontaneous preterm birth is inversely proportional to the duration of preconceptional folate supplementation. Preconceptional folate supplementation was specifically related to early spontaneous preterm birth and not associated with other complications of pregnancy.
Item Type:
Article
Language:
en
MeSH:
Adult; Dietary Supplements; Female; Folic Acid; Humans; Infant, Newborn; Maternal Nutritional Physiological Phenomena; Preconception Care; Pregnancy; Premature Birth; Risk Factors; Vitamin B Complex; Young Adult
ISSN:
1549-1676

Full metadata record

DC FieldValue Language
dc.contributor.authorBukowski, Radeken
dc.contributor.authorMalone, Fergal Den
dc.contributor.authorPorter, Flint Ten
dc.contributor.authorNyberg, David Aen
dc.contributor.authorComstock, Christine Hen
dc.contributor.authorHankins, Gary D Ven
dc.contributor.authorEddleman, Keithen
dc.contributor.authorGross, Susan Jen
dc.contributor.authorDugoff, Lorraineen
dc.contributor.authorCraigo, Sabrina Den
dc.contributor.authorTimor-Tritsch, Ilan Een
dc.contributor.authorCarr, Stephen Ren
dc.contributor.authorWolfe, Honor Men
dc.contributor.authorD'Alton, Mary Een
dc.date.accessioned2011-11-17T12:35:17Z-
dc.date.available2011-11-17T12:35:17Z-
dc.date.issued2009-05-05-
dc.identifier.citationPreconceptional folate supplementation and the risk of spontaneous preterm birth: a cohort study. 2009, 6 (5):e1000061 PLoS Med.en
dc.identifier.issn1549-1676-
dc.identifier.pmid19434228-
dc.identifier.doi10.1371/journal.pmed.1000061-
dc.identifier.urihttp://hdl.handle.net/10147/189827-
dc.description.abstractLow plasma folate concentrations in pregnancy are associated with preterm birth. Here we show an association between preconceptional folate supplementation and the risk of spontaneous preterm birth.-
dc.description.abstractIn a cohort of 34,480 low-risk singleton pregnancies enrolled in a study of aneuploidy risk, preconceptional folate supplementation was prospectively recorded in the first trimester of pregnancy. Duration of pregnancy was estimated based on first trimester ultrasound examination. Natural length of pregnancy was defined as gestational age at delivery in pregnancies with no medical or obstetrical complications that may have constituted an indication for delivery. Spontaneous preterm birth was defined as duration of pregnancy between 20 and 37 wk without those complications. The association between preconceptional folate supplementation and the risk of spontaneous preterm birth was evaluated using survival analysis. Comparing to no supplementation, preconceptional folate supplementation for 1 y or longer was associated with a 70% decrease in the risk of spontaneous preterm delivery between 20 and 28 wk (41 [0.27%] versus 4 [0.04%] spontaneous preterm births, respectively; HR 0.22, 95% confidence interval [CI] 0.08-0.61, p = 0.004) and a 50% decrease in the risk of spontaneous preterm delivery between 28 and 32 wk (58 [0.38%] versus 12 [0.18%] preterm birth, respectively; HR 0.45, 95% CI 0.24-0.83, p = 0.010). Adjustment for maternal characteristics age, race, body mass index, education, marital status, smoking, parity, and history of prior preterm birth did not have a material effect on the association between folate supplementation for 1 y or longer and spontaneous preterm birth between 20 and 28, and 28 to 32 wk (adjusted HR 0.31, 95% CI 0.11-0.90, p = 0.031 and 0.53, 0.28-0.99, p = 0.046, respectively). Preconceptional folate supplementation was not significantly associated with the risk of spontaneous preterm birth beyond 32 wk. The association between shorter duration (<1 y) of preconceptional folate supplementation and the risk of spontaneous preterm birth was not significant after adjustment for maternal characteristics. However, the risk of spontaneous preterm birth decreased with the duration of preconceptional folate supplementation (test for trend of survivor functions, p = 0.01) and was the lowest in women who used folate supplementation for 1 y or longer. There was also no significant association with other complications of pregnancy studied after adjustment for maternal characteristics.-
dc.description.abstractPreconceptional folate supplementation is associated with a 50%-70% reduction in the incidence of early spontaneous preterm birth. The risk of early spontaneous preterm birth is inversely proportional to the duration of preconceptional folate supplementation. Preconceptional folate supplementation was specifically related to early spontaneous preterm birth and not associated with other complications of pregnancy.-
dc.language.isoenen
dc.subject.meshAdult-
dc.subject.meshDietary Supplements-
dc.subject.meshFemale-
dc.subject.meshFolic Acid-
dc.subject.meshHumans-
dc.subject.meshInfant, Newborn-
dc.subject.meshMaternal Nutritional Physiological Phenomena-
dc.subject.meshPreconception Care-
dc.subject.meshPregnancy-
dc.subject.meshPremature Birth-
dc.subject.meshRisk Factors-
dc.subject.meshVitamin B Complex-
dc.subject.meshYoung Adult-
dc.titlePreconceptional folate supplementation and the risk of spontaneous preterm birth: a cohort study.en
dc.typeArticleen
dc.contributor.departmentDepartment of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas, United States of America. rkbukows@utmb.eduen
dc.identifier.journalPLoS medicineen
dc.description.provinceLeinster-

Related articles on PubMed

All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.