BACKGROUND: Women in many countries are advised to increase their folate intake to lower the risk of neural tube defects. For this purpose several countries add folate to the flour. Therefore, it is important to monitor possible adverse effects of this B vitamin. We have assessed the effect of folate on twin pregnancies. METHODS: We conducted a retrospective, population-register based study of 176,042 women who gave birth from December 1998 through the end of 2001. Use of folate and multivitamin supplements was recorded on the mandatory birth notification form of the Medical Birth Registry of Norway. Pregnancies after in vitro fertilization (IVF) were reported separately. RESULTS: With adjustment for maternal age and parity, we observed an increased risk of twin pregnancies associated with preconceptional use of folate (odds ratio = 1.59; 95% confidence interval = 1.41-1.78). This association was largely explained by confounding with IVF pregnancies, which were strongly associated both with twin pregnancies and folate use. After exclusion of known IVF pregnancies, and accounting for underreporting of both IVF pregnancies and folate use, the risk was no longer elevated (1.02; 0.85-1.24). Weak associations with twin pregnancies were observed for use of multivitamins and folate during pregnancy, but could be due to increased use of vitamins after a recognized twin pregnancy. CONCLUSIONS: The association between preconceptional folate use and twin pregnancies was strongly confounded by IVF. After accounting for IVF pregnancies and underreporting, we found no evidence for an association between preconceptional folate supplements and twinning.
BACKGROUND:Women in many countries are advised to increase their folate intake to lower the risk of neural tube defects. For this purpose several countries add folate to the flour. Therefore, it is important to monitor possible adverse effects of this B vitamin. We have assessed the effect of folate on twin pregnancies. METHODS: We conducted a retrospective, population-register based study of 176,042 women who gave birth from December 1998 through the end of 2001. Use of folate and multivitamin supplements was recorded on the mandatory birth notification form of the Medical Birth Registry of Norway. Pregnancies after in vitro fertilization (IVF) were reported separately. RESULTS: With adjustment for maternal age and parity, we observed an increased risk of twin pregnancies associated with preconceptional use of folate (odds ratio = 1.59; 95% confidence interval = 1.41-1.78). This association was largely explained by confounding with IVF pregnancies, which were strongly associated both with twin pregnancies and folate use. After exclusion of known IVF pregnancies, and accounting for underreporting of both IVF pregnancies and folate use, the risk was no longer elevated (1.02; 0.85-1.24). Weak associations with twin pregnancies were observed for use of multivitamins and folate during pregnancy, but could be due to increased use of vitamins after a recognized twin pregnancy. CONCLUSIONS: The association between preconceptional folate use and twin pregnancies was strongly confounded by IVF. After accounting for IVF pregnancies and underreporting, we found no evidence for an association between preconceptional folate supplements and twinning.
Authors: Cathrine Hoyo; Amy P Murtha; Joellen M Schildkraut; Randy L Jirtle; Wendy Demark-Wahnefried; Michele R Forman; Edwin S Iversen; Joanne Kurtzberg; Francine Overcash; Zhiqing Huang; Susan K Murphy Journal: Epigenetics Date: 2011-07-01 Impact factor: 4.528
Authors: Cathrine Hoyo; Anne Kjersti Daltveit; Edwin Iversen; Sara E Benjamin-Neelon; Bernard Fuemmeler; Joellen Schildkraut; Amy P Murtha; Francine Overcash; Adriana C Vidal; Frances Wang; Zhiqing Huang; Joanne Kurtzberg; Victoria Seewaldt; Michele Forman; Randy L Jirtle; Susan K Murphy Journal: Epigenetics Date: 2014-05-29 Impact factor: 4.528
Authors: Susan E Puumala; Susan E Carozza; Eric J Chow; Erin E Fox; Scott Horel; Kimberly J Johnson; Colleen McLaughlin; Beth A Mueller; Peggy Reynolds; Julie Von Behren; Logan G Spector Journal: Cancer Epidemiol Biomarkers Prev Date: 2009-01 Impact factor: 4.254
Authors: Cathrine Hoyo; Amy P Murtha; Joellen M Schildkraut; Michele R Forman; Brian Calingaert; Wendy Demark-Wahnefried; Joanne Kurtzberg; Randy L Jirtle; Susan K Murphy Journal: BMC Public Health Date: 2011-01-21 Impact factor: 3.295
Authors: Renata Bortolus; Fenneke Blom; Francesca Filippini; Mireille N M van Poppel; Emanuele Leoncini; Denhard J de Smit; Pier Paolo Benetollo; Martina C Cornel; Hermien E K de Walle; Pierpaolo Mastroiacovo Journal: BMC Pregnancy Childbirth Date: 2014-05-13 Impact factor: 3.007