PURPOSE: We examined whether high doses of folic acid and iron supplementation in early-to-mid pregnancy affect the risk of preterm birth, low birth weight, and small for gestational age neonates, in the mother-child cohort in Crete, Greece (Rhea study). METHODS: We included 1,279 women with singleton pregnancies with complete data on supplements use in early-to-mid pregnancy and birth outcomes. Anthropometric measurements at birth were obtained from medical records. Red blood cell folate concentrations in cord blood were measured in a subsample of the study population (n = 58). RESULTS: Sixty-six percent of the study participants reported high doses of supplemental folic acid use (5 mg/day), while 21 % reported excessive doses of folic acid use (>5 mg/day) in early-to-mid pregnancy. Daily intake of 5-mg supplemental folic acid was associated with a 31 % decrease in the risk of preterm birth (RR, 0.69; 95 % CI, 0.44, 0.99), 60 % decrease in the risk of delivering a low birth weight neonate (RR, 0.40; 95 % CI, 0.21, 0.76), and 66 % decrease in the risk of delivering a small for gestational age (SGA) neonate (RR, 0.34; 95 % CI, 0.16, 0.73). Daily doses of iron supplementation more than 100 mg were associated with a twofold increased risk for SGA neonates (RR, 2.14; 95 % CI, 0.99, 5.97). CONCLUSION: These findings suggest that high daily doses of supplementary folic acid in early-to-mid pregnancy may be protective for preterm birth, low birth weight, and small for gestational age neonates, while high daily doses of supplementary iron may be harmful for fetal growth.
PURPOSE: We examined whether high doses of folic acid and iron supplementation in early-to-mid pregnancy affect the risk of preterm birth, low birth weight, and small for gestational age neonates, in the mother-child cohort in Crete, Greece (Rhea study). METHODS: We included 1,279 women with singleton pregnancies with complete data on supplements use in early-to-mid pregnancy and birth outcomes. Anthropometric measurements at birth were obtained from medical records. Red blood cell folate concentrations in cord blood were measured in a subsample of the study population (n = 58). RESULTS: Sixty-six percent of the study participants reported high doses of supplemental folic acid use (5 mg/day), while 21 % reported excessive doses of folic acid use (>5 mg/day) in early-to-mid pregnancy. Daily intake of 5-mg supplemental folic acid was associated with a 31 % decrease in the risk of preterm birth (RR, 0.69; 95 % CI, 0.44, 0.99), 60 % decrease in the risk of delivering a low birth weight neonate (RR, 0.40; 95 % CI, 0.21, 0.76), and 66 % decrease in the risk of delivering a small for gestational age (SGA) neonate (RR, 0.34; 95 % CI, 0.16, 0.73). Daily doses of iron supplementation more than 100 mg were associated with a twofold increased risk for SGA neonates (RR, 2.14; 95 % CI, 0.99, 5.97). CONCLUSION: These findings suggest that high daily doses of supplementary folic acid in early-to-mid pregnancy may be protective for preterm birth, low birth weight, and small for gestational age neonates, while high daily doses of supplementary iron may be harmful for fetal growth.
Authors: J Rolschau; K Kristoffersen; M Ulrich; P Grinsted; E Schaumburg; N Foged Journal: Eur J Obstet Gynecol Reprod Biol Date: 1999-12 Impact factor: 2.435
Authors: Bernard F Cole; John A Baron; Robert S Sandler; Robert W Haile; Dennis J Ahnen; Robert S Bresalier; Gail McKeown-Eyssen; Robert W Summers; Richard I Rothstein; Carol A Burke; Dale C Snover; Timothy R Church; John I Allen; Douglas J Robertson; Gerald J Beck; John H Bond; Tim Byers; Jack S Mandel; Leila A Mott; Loretta H Pearson; Elizabeth L Barry; Judy R Rees; Norman Marcon; Fred Saibil; Per Magne Ueland; E Robert Greenberg Journal: JAMA Date: 2007-06-06 Impact factor: 56.272
Authors: Radek Bukowski; Fergal D Malone; Flint T Porter; David A Nyberg; Christine H Comstock; Gary D V Hankins; Keith Eddleman; Susan J Gross; Lorraine Dugoff; Sabrina D Craigo; Ilan E Timor-Tritsch; Stephen R Carr; Honor M Wolfe; Mary E D'Alton Journal: PLoS Med Date: 2009-05-12 Impact factor: 11.069
Authors: C S Yajnik; S S Deshpande; A A Jackson; H Refsum; S Rao; D J Fisher; D S Bhat; S S Naik; K J Coyaji; C V Joglekar; N Joshi; H G Lubree; V U Deshpande; S S Rege; C H D Fall Journal: Diabetologia Date: 2007-09-13 Impact factor: 10.122
Authors: Kathleen M Antony; Jun Ma; Kristen B Mitchell; Diana A Racusin; James Versalovic; Kjersti Aagaard Journal: Am J Obstet Gynecol Date: 2014-12-31 Impact factor: 8.661