Maternal folic acid supplementation for the prevention of preeclampsia: A systematic review and meta-analysis.

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dc.contributor.author Bulloch, Rhodi E en
dc.contributor.author Lovell, Amy en
dc.contributor.author Jordan-Cole, Vanessa en
dc.contributor.author McCowan, Lesley en
dc.contributor.author Thompson, John en
dc.contributor.author Wall, Clare en
dc.date.accessioned 2020-02-11T23:28:33Z en
dc.date.issued 2018-07 en
dc.identifier.issn 0269-5022 en
dc.identifier.uri http://hdl.handle.net/2292/49936 en
dc.description.abstract BACKGROUND:Preeclampsia is a significant contributor to maternal and neonatal morbidity and mortality. Folic acid supplementation is recommended periconceptionally for the prevention of neural tube defects. Epidemiological evidence suggests that maternal folic acid supplementation may play a role in preventing other adverse birth outcomes. This systematic review aimed to investigate the effect of maternal folic acid supplementation during pregnancy on risk of preeclampsia and gestational hypertension. METHODS:Multiple scientific databases and grey literature were searched for relevant studies. Studies were reviewed according to pre-specified inclusion and exclusion criteria. Study characteristics were summarised and study quality was assessed. A meta-analysis of observational studies was conducted to examine the effect of maternal folic acid supplementation on preeclampsia risk. RESULTS:Meta-analysis of eight observational studies showed significantly lower odds of preeclampsia with folic acid supplementation in comparison to no folic acid supplementation: OR = 0.78 (95% CI 0.63, 0.98), with moderately high heterogeneity between studies. Subgroup analysis showed no significant subgroup difference between folic acid supplementation taken by itself, in comparison to folic acid taken in or alongside a multivitamin. CONCLUSION:Low level evidence is available for a modest association between maternal folic acid supplementation and reduction in preeclampsia risk. Future studies should differentiate between early and late onset and mild vs severe preeclampsia, and should control for relevant confounders including the presence of multivitamin supplements. The protocol for this systematic review was prospectively registered with PROSPERO (CRD42015029310). en
dc.format.medium Print-Electronic en
dc.language eng en
dc.relation.ispartofseries Paediatric and perinatal epidemiology en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.subject Humans en
dc.subject Pregnancy Complications en
dc.subject Pre-Eclampsia en
dc.subject Folic Acid en
dc.subject Pregnancy Outcome en
dc.subject Evidence-Based Medicine en
dc.subject Pregnancy en
dc.subject Dietary Supplements en
dc.subject Female en
dc.title Maternal folic acid supplementation for the prevention of preeclampsia: A systematic review and meta-analysis. en
dc.type Journal Article en
dc.identifier.doi 10.1111/ppe.12476 en
pubs.issue 4 en
pubs.begin-page 346 en
pubs.volume 32 en
dc.rights.holder Copyright: The author en
pubs.end-page 357 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Meta-Analysis en
pubs.subtype Systematic Review en
pubs.subtype Journal Article en
pubs.elements-id 744296 en
pubs.org-id Medical and Health Sciences en
pubs.org-id Medical Sciences en
pubs.org-id Nutrition en
pubs.org-id School of Medicine en
pubs.org-id Obstetrics and Gynaecology en
pubs.org-id Paediatrics Child & Youth Hlth en
dc.identifier.eissn 1365-3016 en
pubs.record-created-at-source-date 2018-06-09 en
pubs.dimensions-id 29882975 en


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