Supplementation of folic acid in pregnancy and the risk of preeclampsia and gestational hypertension: a meta-analysis - PubMed (original) (raw)

Meta-Analysis

Supplementation of folic acid in pregnancy and the risk of preeclampsia and gestational hypertension: a meta-analysis

Cheng Liu et al. Arch Gynecol Obstet. 2018 Oct.

Abstract

Objectives: We aimed to systematically assess the relationship between folic acid supplementation in pregnancy and risk of preeclampsia and gestational hypertension.

Methods: The relevant studies were included by retrieving the Embase, PubMed and Cochrane library databases. Data extraction was conducted by two investigators independently. The risk ratio (RR) and 95% confidence interval (CI) were used as effect indexes to evaluate the relationship between folic acid supplementation and risk of gestational hypertension or preeclampsia. A subgroup analysis was performed according to the supplementation patterns of folic acid. The homogeneity of the effect size was tested across the studies, and publication biases were examined.

Results: In total, 13 cohort studies and 1 randomized controlled trial study was included, containing 160,562 and 149,320 women with and without folic acid supplementation during pregnancy. Pooled results showed that risk of gestational hypertension was not associated with the supplementation of folic acid. However, folic acid supplementation during pregnancy could significantly reduce the risk of preeclampsia. Moreover, the results of subgroup analysis showed that the decreased preeclampsia risk was associated with supplementation of multivitamins containing folic acid rather than folic acid alone.

Conclusions: Our findings indicate that the supplementation of multivitamins containing folic acid during pregnancy could significantly lower preeclampsia risk.

Keywords: Folic acid; Meta-analysis; Risk of gestational hypertension; Risk of preeclampsia.

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Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Figures

Fig. 1

Fig. 1

Flowchart of the literature search and study selection

Fig. 2

Fig. 2

Forest plot of the association between folic acid supplementation and risk of gestational hypertension. CI confidence interval

Fig. 3

Fig. 3

Forest plot of the association between folic acid supplementation and risk of preeclampsia. CI confidence interval

Fig. 4

Fig. 4

Forest plot of the association between different patterns of folic acid supplementation and risk of preeclampsia. CI confidence interval

Fig. 5

Fig. 5

A sensitivity analysis for publication bias of the included studies. CI confidence interval

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References

    1. Ayansina D, Black C, Hall S, Marks A, Millar C, Prescott G, Wilde K, Bhattacharya S. Long term effects of gestational hypertension and pre-eclampsia on kidney function: record linkage study. Pregnancy Hypertens. 2016;6(4):344–349. doi: 10.1016/j.preghy.2016.08.231. - DOI - PMC - PubMed
    1. Masoudian P, Nasr A, de Nanassy J, Fung-Kee-Fung K, Bainbridge SA, El Demellawy D. Oocyte donation pregnancies and the risk of preeclampsia or gestational hypertension: a systematic review and metaanalysis. Am J Obstet Gynecol. 2016;214(3):328–339. doi: 10.1016/j.ajog.2015.11.020. - DOI - PubMed
    1. McGinnis R, Steinthorsdottir V, Williams NO, Thorleifsson G, Shooter S, Hjartardottir S, Bumpstead S, Stefansdottir L, Hildyard L, Sigurdsson JK. Variants in the fetal genome near FLT1 are associated with risk of preeclampsia. Nat Genet. 2017;49(8):1255–1260. doi: 10.1038/ng.3895. - DOI - PubMed
    1. Al-Jameil N, Khan FA, Khan MF, Tabassum H. A brief overview of preeclampsia. J Clin Med Res. 2014;6(1):1. doi: 10.5897/JCMR11.057. - DOI - PMC - PubMed
    1. Nomura Y, John RM, Janssen AB, Davey C, Finik J, Buthmann J, Glover V, Lambertini L. Neurodevelopmental consequences in offspring of mothers with preeclampsia during pregnancy: underlying biological mechanism via imprinting genes. Arch Gynecol Obstet. 2017;295(6):1319–1329. doi: 10.1007/s00404-017-4347-3. - DOI - PMC - PubMed

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