American Journal of Obstetrics & Gynecology
Volume 198, Issue 1 , Pages 45.e1-45.e7, January 2008

Folic acid supplementation in early second trimester and the risk of preeclampsia

  • Shi Wu Wen, MB, PhD

      Affiliations

    • OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
    • Department of Epidemiology and Community Medicine, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
    • Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ontario, Canada
    • Corresponding Author InformationReprints: Shi Wu Wen, MB, PhD, OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Faculty of Medicine, 501 Smyth Rd, Box 241, Ottawa, Ontario, Canada K1H 8L6
    • ,
  • Xi-Kuan Chen, MD, PhD

      Affiliations

    • OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
    • Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ontario, Canada
    • ,
  • Marc Rodger, MD

      Affiliations

    • Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ontario, Canada
    • Division of Hematology, Department of Medicine, Queen’s University School of Medicine, Kingston, ON
    • ,
  • Ruth Rennicks White, RN, BScN

      Affiliations

    • OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
    • Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ontario, Canada
    • ,
  • Qiuying Yang, MD, PhD

      Affiliations

    • OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
    • Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ontario, Canada
    • ,
  • Graeme N. Smith, MD, PhD

      Affiliations

    • Queen’s Perinatal Research Unit, Kingston General Hospital, and the Department of Obstetrics and Gynecology, Queen’s University School of Medicine, Kingston, ON
    • ,
  • Ronald J. Sigal, MD, MPH

      Affiliations

    • Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ontario, Canada
    • Department of Medicine, Queen’s University School of Medicine, Kingston, ON
    • Division of Endocrinology, University of Calgary, Calgary, AB, Canada.
    • ,
  • Sherry L. Perkins, PhD

      Affiliations

    • Division of Biochemistry, Queen’s University School of Medicine, Kingston, ON
    • ,
  • Mark C. Walker, MD, MSc

      Affiliations

    • OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
    • Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ontario, Canada

Received 20 November 2006; received in revised form 17 April 2007; accepted 29 June 2007.

Objective

The objective of the study was to evaluate the association between folic acid supplementation in early second trimester and the risk of developing preeclampsia.

Study Design

We carried out a prospective cohort study between October 2002-December 2005. We recruited women who had their prenatal care visit (12-20 weeks’ gestation) at the Ottawa Hospital and Kingston General Hospital. All charts for participants with a diagnosis of preeclampsia were audited and blindly adjudicated by 4 study investigators to validate the diagnosis.

Results

A total of 2951 pregnant women were included in the final analysis. Supplementation of multivitamins containing folic acid was associated with increased serum folate (on average 10.51 μmol/L), decreased plasma homocysteine (on average 0.39 μmol/L), and reduced risk of preeclampsia (adjusted odds ratio, 0.37; 95% confidence interval, 0.18-0.75).

Conclusion

Supplementation of multivitamins containing folic acid in the second trimester is associated with reduced risk of preeclampsia.

Key words: 5, 10-methylenetetrahydrofolate reductase, folic acid, homocysteine, preeclampsia, supplementation

 

 Cite this article as: Wen SW, Chen X-K, Rodger M, et al. Folic acid supplementation in early second trimester and the risk of preeclampsia. Am J Obstet Gynecol 2008;198:45.e1-45.e7.Supported in part by a grant from the Canadian Institute for Health Research (Grant MOP 53188). S.W.W., G.N.S., R.J.S., and M.C.W. are recipients of a New Investigators’ Award from the Canadian Institute for Health Research. M.R. is a Clinical Investigator of the Heart and Stroke Foundation of Canada, and X.-K.C. and Q.Y. are Canadian Institute for Health Research/Strategic Training Initiatives of Research in Reproductive Health Sciences postdoctor fellows.

PII: S0002-9378(07)00844-7

doi:10.1016/j.ajog.2007.06.067

American Journal of Obstetrics & Gynecology
Volume 198, Issue 1 , Pages 45.e1-45.e7, January 2008

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