Periconceptional Folic Acid Supplementation and the Risk of Spontaneous Abortion among Women Who Prepared to Conceive: Impact of Supplementation Initiation Timing

It is unclear whether periconceptional folic acid (FA) supplementation decreases the risk of spontaneous abortion (SA). The impact of supplementation initiation timing has not been ascertained. This cohort study aimed to investigate the association between maternal periconceptional FA supplementatio...

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Bibliographic Details
Published in:Nutrients 2020-07, Vol.12 (8), p.2264
Main Authors: Mao, Yan-Yan, Yang, Liu, Li, Min, Liu, Jun, Zhu, Qian-Xi, He, Yang, Zhou, Wei-Jin
Format: Article
Language:English
Subjects:
Abortion
Abortion, Spontaneous - epidemiology
Abortion, Spontaneous - prevention & control
Acids
Adult
Birth defects
China - epidemiology
Chronic illnesses
Cohort Studies
Confidence intervals
Cytomegalovirus
Dietary Supplements
Ethnicity
Female
Fertilization
Folic acid
Folic Acid - therapeutic use
Health care
Humans
Infections
initial time
Maternal & child health
Miscarriage
periconceptional
Preconception Care - methods
Preconception Care - statistics & numerical data
Pregnancy
Risk
Smoking
spontaneous abortion
Stillbirth
Studies
supplementation
Time Factors
Vitamin B
Womens health
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Summary:It is unclear whether periconceptional folic acid (FA) supplementation decreases the risk of spontaneous abortion (SA). The impact of supplementation initiation timing has not been ascertained. This cohort study aimed to investigate the association between maternal periconceptional FA supplementation and risk of SA, with due consideration of the supplementation initiation timing. Through the National Free Pre-conception Health Examination Project (NFPHEP), we identified 65,643 pregnancies on FA supplementation in Chongqing, China between 2010 and 2015. After adjusting for covariates, maternal periconceptional FA supplementation was associated with a lower risk of SA (adjusted risk ratio [aRR]: 0.52; 95% confidence interval [CI]: 0.48-0.56). Pregnant women with FA supplementation initiated at least 3 months before conception had a 10% lower risk of SA (aRR: 0.46; 95% CI: 0.42-0.50) than those with FA supplementation initiated 1-2 months before conception (aRR: 0.56; 95% CI: 0.50-0.62) or after conception (aRR: 0.56; 95% CI: 0.51-0.61). These associations might not thoroughly account for FA supplementation, and to some extent our findings confirm the role of the utilization of healthcare in preventing SAs. Women who initiated healthcare, including taking FA earlier during the periconceptional period, could have a lower risk of SA.
ISSN:2072-6643
2072-6643
DOI:10.3390/nu12082264