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Odds ratios, with 95% confidence intervals, for placental abruption among 280,127 singleton deliveries in the Medical Birth Registry of Norway, 1999-2004, according to maternal vitamin supplement use
Source publication
The authors investigated a possible association of supplemental folic acid and multivitamin use with placental abruption by using data on 280,127 singleton deliveries recorded in 1999-2004 in the population-based Medical Birth Registry of Norway. Odds ratios, adjusted for maternal age, marital status, parity, smoking, pregestational diabetes, and c...
Contexts in source publication
Context 1
... logistic regression analyses showed that those who had taken folic acid and/or multivitamin supplements before or any time during the pregnancy had a 26 percent reduction in the risk of overall placental abruption (adjusted odds ratio (OR) ¼ 0.74, 95 percent confidence interval (CI): 0.65, 0.84) and a 40 percent reduction in the risk of preterm abruption (adjusted OR ¼ 0.60, 95 percent CI: 0.49, 0.73), after adjustment for maternal age, marital status, parity, smoking, pregestational diabetes, and chronic hyper- tension (table 2). Exclusion of women who developed preeclampsia did not alter the overall effect estimates (OR ¼ 0.75, 95 percent CI: 0.65, 0.86). ...
Context 2
... also investigated placental abruption in relation to time period of folic acid and/or multivitamin supplement intake: before and during pregnancy, during pregnancy only, and before pregnancy only (table 2). The odds ratios did not change by time period of use for either placental abruption overall or preterm abruption. ...
Citations
... In this study, the prevalence of AP was 0.84%. This result is consistent with the results of other studies from Iran, Pakistan, India, and Norway, which showed AP frequencies of 1%, 1.03%, and 0.4%, respectively [24][25][26]. On the other hand, higher frequencies were reported in other studies from Pakistan, India, and Sudan, which reported AP rates of 3.7% [27], 4.4% [28], and 6.5% [29], respectively. These variations in frequency could be due to differences in diagnostic criteria used or differences in study populations, or insufficient recording of AP cases in some centers. ...
Background: Placental abruption is a serious obstetric complication with many potential adverse outcomes for both mother and fetus. The aim of this study was to determine the clinical characteristics, risk factors, and maternal and perinatal consequences of placental abruption among pregnant women, at Al-Sadka Teaching Hospital. Methods: This was a prospective descriptive study including women with placental abruption, who delivered at Al-Sadka University Hospital, Aden, Yemen, during the period from August 01, 2015, to September 31, 2016. Statistical analysis of the data was performed with (statistics is a statistical software version 24). Results: The frequency of placental abruption in this study was 0.84%. The majority of women with placental abruption were in the 20–25 age group (34.3%), multiparous (51.4%), had no antenatal care (ANC) (51.4%). and illiterate (37.1%). The most common clinical presentation was vaginal bleeding (82.9%), followed by tetanic uterine contractions (68.6%). The most common risk factors associated with placental abruption were pre-eclampsia (34.5%) and premature rupture of membrane (21.8%). Most of our patients (77.1%) had a vaginal delivery, while the rest had a cesarean section delivery. The most common maternal complications were postpartum hemorrhage (100%) and hemorrhagic shock (27.5%). Perinatal death was more commonly associated with pre-eclampsia (55.0%), severe placental abruption (95%), and preterm birth (70%). On the other hand, perinatal death was reported in 28.6% of our patients (n=20). A higher percentage of fetuses born by cesarean section died (56.3%), while 79.6% of vaginal deliveries involved live fetuses. Conclusion: The frequency of placental abruption was 0.84%. Women with abruptio placenta had a higher likelihood of being illiterate, between 20 and 25-year-old, multipara, and receiving inadequate ANC. Accordingly, we recommend raising women’s awareness of the importance of ANC through the media (television and radio) and creating policies to encourage high-quality routine prenatal care for all pregnant women by policymakers, particularly the Ministry of Public Health.
... The micronutrients that receive the most attention in pregnancy, and are commonly provided as supplements, include vitamins A, D, E, folate, B12, B6, and C, iron, zinc, iodine, copper and selenium. 13 Although the other B-complex vitamins (e.g., niacin, riboflavin and thiamin) are almost always included in dietary supplements, the role of metabolism in pregnancy is still not widely known but may influence placental health. 14 Consequently, to describe the contribution of B vitamins, focus is on folate and vitamin B12, which support its function in pregnancy, especially in the formation of maternal erythrocytes and the prevention of congenital abnormalities. ...
Congenital diseases are damaging to the fetus and have an influence on the length of pregnancy. Some congenital problems can still be fixed after birth, however the costs are significant. Prophylaxis is strongly advocated to reduce the risk of congenital abnormalities during preconception. The incidence of congenital anomalies in the first pregnancy is associated with a 2.5-fold increased risk of recurrence in future pregnancies. The likelihood of recurrence is more than 24 times larger for the same type of aberration, but just 1.4 times for separate anomalies. The MTHFR-folate gene polymorphism has been related to an increased frequency of neural tube anomalies. Infectious diseases and environmental teratogens have an effect on genetic or epigenetic factors. Environmental elements that are repeated such maternal diabetes, obesity, and nutritional shortages seem to increase the incidence of fetal malformations. Alcohol, nicotine, or psychotropic drugs can all be teratogens. The promotion of contraceptive usage, optimization of weight and micronutrient status, prevention and management of infectious illnesses, birth spacing and the prevention of adolescent pregnancy, screening for and the management of chronic diseases are a few of these interventions. In conclusion, the probability of recurrence is quite high in the category of congenital defects, particularly for similar anomalies. Structural abnormalities can be decreased even further with proper planning and preparation, especially in high-risk populations. Moreover, preconception intervention have the potential to minimize congenital malformations.
... Placental abruption is a clinical diagnosis, typically characterized by vaginal bleeding, abdominal pain, uterine contractions and/or tenderness, and sometimes non-reassuring foetal monitoring. 2 Short interpregnancy intervals may also contribute to depletion of maternal folate status, leading to adverse outcomes in later pregnancies. 3 Inadequate maternal folate status has been linked to abruptio placentae, preeclampsia, spontaneous abortion, stillbirth, preterm delivery, and low birthweight. Perhaps the strongest associations have been with abruptio placentae. ...
Background: Over the course of pregnancy, there is a steady decline in maternal plasma folate concentration and vitamin B12 concentration about 50%of non pregnant levels. Insufficient folate and vitamin B12 status has been associated with many reproductive complications including abruption, IUGR, pre eclampsia, early pregnancy loss. The aim of the study was to determine the role of serum folic acid and vitamin B12levels in patients with abruptio placentae and to study the feto-maternal outcome in these patients. Feto maternal outcome is seen in terms of mode of delivery whether vaginal or caesarean, period of gestation whether term or preterm, need of blood transfusion, stillbirths. Methods: In this prospective observational study conducted in a tertiary hospital from 2018-2020, 50 pregnant women with abruptio placentae were included and their serum folic acid and vitamin B12 levels were measured by ELIZA method using commercially available kits. Results: Serum folic acid levels were not low in the cases of placental abruption with range= 25 ng/ml to 80.5 ng/ml. Mean folic acid level ±SD is 47.98±13.15 ng/ml and median is 48 ng/ml. In this study vitamin B12 levels were low in the cases, range 14 pg/ml to 70 pg/ml. Mean vitamin B12 value ±SD is 27.15±11.63 pg/ml and median is 25 pg/ml.The rate of caesarean section was 44%, preterm delivery was 64% and stillbirth was 38% in these cases with mean folic acid levels of 48.7±15.4 ng/ml, 46.94±13.85 ng/ml and 46.03±8.13 ng/ml respectively and mean vitamin B12 levels of 23.34±6.74 pg/ml, 28.73±13.44 pg/ml and 28.32±11.75 pg/ml respectively. There was a significant association (p=0.006) between vitamin B12 and mode of delivery. No other significant association was seen between serum folic acid and vitamin B12 levels and the different fetomaternal outcome. Conclusions: Low levels of vitamin B12 is seen in cases with abruptio placentae. The rate of caesarean section, preterm delivery, stillbirth and need of blood transfusion is high but no significant association is seen.
... This evidence has also stimulated research into the association between folic acid supplementation during pregnancy and pregnancy outcomes. Increased intake of this vitamin reduces the risk of cleft lip and palate, pre-eclampsia, placental abruption, spontaneous abortion, and gestational hypertension [6][7][8][9][10]. Findings on the effect of folic acid supplementation during the peri-conceptional period (including preconception and the first trimester of pregnancy) on the offspring's growth and development have been inconsistent. ...
Background:
Maternal lack of folic acid supplementation during pregnancy may increase the risk of low birth weight and preterm delivery. However, little is known about the relationship between folic acid supplementation during pregnancy and the physical development of offspring in the later stage.
Objective:
This study aimed to explore the association between maternal folic acid supplementation status during pregnancy and the physical development of preschool children.
Methods:
A total of 3064 mother-child pairs with data on maternal folic acid supplementation status during pregnancy and children's anthropometric measurements were recruited from the Ma'anshan-Anhui Birth Cohort (MABC) in China. Maternal folic acid supplementation status during pregnancy was the main exposure, and the primary outcomes were children's growth development trajectories. Children's growth development trajectories were fitted using group-based trajectory models. The association between maternal folic acid supplementation status during pregnancy and children's growth trajectories was performed using multiple logistic regression models.
Results:
After adjusting for potential confounders, we found that the absence of maternal folic acid supplementation before pregnancy and in the first trimester was significantly associated with a "high level" trajectory (trajectory 3) and a "high rising level" trajectory (trajectory 4) of BMI-Z scores in children 0 to 6 years of age (OR = 1.423, 95%CI:1.022-1.982; OR = 1.654, 95%CI: 1.024-2.671). In children aged 4 to 6 years old, a "high level" trajectory (trajectory 3) of body fat ratio was substantially related to maternal no folic acid supplementation before pregnancy and in the first trimester (OR = 1.833, 95%CI:1.037-3.240). No significant additional benefits associated with physical developmental indicators in preschool children have been observed with continued folic acid supplementation after the first trimester of gestation.
Conclusions:
Maternal non-supplementation with folic acid during pregnancy is associated with a "high level" BMI trajectory and a "high level" body fat ratio trajectory in preschool-aged children.
... The MBRN also provided information on maternal age at birth (in years), year of childbirth, parity, and interpregnancy interval (in months). The interpregnancy interval was calculated as the time between the birth of a first child to an estimated conception of a second child (time of birth minus gestational age) to the same woman [29]. Length of residence (immigrants only) was calculated as the difference between year of childbirth of the first child (data from the MBRN) and year of official residence permit in Norway for the mother (data from Statistics Norway). ...
In this nationwide population-based study, we investigated the associations of preeclampsia in the first pregnancy with the risk of preeclampsia in the second pregnancy, by maternal country of birth using data from the Medical Birth Registry of Norway and Statistics Norway (1990–2016). The study population included 101,066 immigrant and 544,071 non-immigrant women. Maternal country of birth was categorized according to the seven super-regions of the Global Burden of Disease study (GBD). The associations between preeclampsia in the first pregnancy with preeclampsia in the second pregnancy were estimated using log-binomial regression models, using no preeclampsia in the first pregnancy as the reference. The associations were reported as adjusted risk ratios (RR) with 95% confidence intervals (CI), adjusted for chronic hypertension, year of first childbirth, and maternal age at first birth. Compared to those without preeclampsia in the first pregnancy, women with preeclampsia in the first pregnancy were associated with a considerably increased risk of preeclampsia in the second pregnancy in both immigrant (n = 250; 13.4% vs. 1.0%; adjusted RR 12.9 [95% CI: 11.2, 14.9]) and non-immigrant women (n = 2876; 14.6% vs. 1.5%; adjusted RR 9.5 [95% CI: 9.1, 10.0]). Immigrant women from Latin America and the Caribbean appeared to have the highest adjusted RR, followed by immigrant women from North Africa and the Middle East. A likelihood ratio test showed that the variation in adjusted RR across all immigrant and non-immigrant groups was statistically significant (p = 0.006). Our results suggest that the association between preeclampsia in the first pregnancy and preeclampsia in the second pregnancy might be increased in some groups of immigrant women compared with non-immigrant women in Norway.
... Foliany dobrze wchłaniają się z jelit i wiążą z białkami osocza [2]. Wszystkim kobietom planującym ciążę należy zalecić przyjmowanie kwasu foliowego, aby zmniejszyć ryzyko poronienia oraz urodzenia dziecka z wadą cewy nerwowej, rozszczepem wargi lub podniebienia, wadami serca [28,29,30,6]. Cewa nerwowa zamyka się między 24 a 26 dniem po zapłodnieniu, tak więc rozpoczęcie suplementacji kwasu foliowego po rozpoznaniu ciąży jest zwykle zbyt późne, aby zmniejszyć ryzyko powstania wad. Zgodnie z rekomendacjami Polskiego Towarzystwa Ginekologów i Położników u pacjentek z dodatnim wywiadem w kierunku wrodzonych wad cewy nerwowej w poprzedniej ciąży, zalecane jest stosowanie 4 mg/dobę kwasu foliowego w ściśle określonym czasie, tj. ...
Introduction and purpose
Nutrition in the preconception phase as well as during pregnancy represents one of the most important factors that affect the development and well-being of the fetus and newborn. The aim of this study was to evaluate the dietary supplements during preconception among Polish women from the Lublin Province.
Material and methods
The survey was conducted in a population of 260 women, who were randomly included in the study. The women were asked to anonymously complete a questionnaire regarding the possible intake of supplementation. The questions included in the questionnaire concerned the frequency and type of dietary supplements taken.
Results
A slight majority of women (53%) did not take dietary supplements during the contraceptive period. The most commonly used was folic acid (45%), the least frequently - vitamin A (2%). The frequency of using dietary supplements by women in the pre-conception period does not correlate with the level of their place of residence, financial situation or age, however, it is related to the level of education - people with higher education used supplementation more often before pregnancy. Women's awareness of supplementation during pregnancy increases significantly. Women take many more supplements during pregnancy than they took before pregnancy. The average supplementation before pregnancy was 0.48, and during pregnancy it increases significantly and amounts to 0.83.
Conclusions
Women's awareness of supplementation during pregnancy increases significantly. Women take many more supplements during pregnancy than they took before pregnancy.The awareness of women should be increased and supplementation of recommended nutrients should be improved in order to prevent the effects of supplements deficiency.
... The same is true for vitamin deficiencies and folate deficiencies, whose influence on the course of pregnancy is evidenced by the reduction in the risk of placental abruption in the event of folate supplementation alone (OR = 0.81) or multivitamin. (OR = 0.72) [16]. ...
... In 2015, a Cochrane review [1] confirmed that FA, alone or in combination with vitamins and minerals, prevents the first and second time Nutrients 2021, 13, 4422 2 of 14 occurrence of NTDs, but did not find a clear effect on other birth defects (namely cleft palate, cleft lip, congenital cardiovascular defects) as previously suggested [2,3]. Moreover, the available literature offers an uncertain impact of FA supplementation on fertility and prevention of other adverse reproductive outcomes [4][5][6][7][8][9][10][11][12][13][14][15][16]. Observational studies indicated an association between greater level of folate during pregnancy and higher birthweight [6] and fewer cases of small for gestational age (SGA) [7,8] and preterm delivery [9], although such findings were not reported in other investigations [10,11]. ...
... To date, the relationship between folate insufficiency and the onset of placenta mediated diseases, such as spontaneous abortion, preterm birth, fetal growth restriction, preeclampsia [13,14], abruptio placentae [15] and stillbirth [2,16] is not fully understood, and the issue of the most suitable dose of FA is still open [17,18]. ...
Folic acid (FA) supplementation prevents neural tube defects (NTDs), but the effects on other reproductive outcomes are unclear. While common recommendation is 0.4 mg/day in addition to regular nutrition, the most appropriate dose of FA is still under debate. We investigated the effects of a higher dose of periconception FA on reducing adverse reproductive outcomes. In this multicenter double-blind randomized controlled trial (RCT), 1060 women (aged 18–44 years and planning a pregnancy) were randomly assigned to receive 4.0 mg or 0.4 mg of FA daily. The primary outcome was the occurrence of congenital malformations (CMs). A composite outcome including one or more adverse pregnancy outcomes was also evaluated. A total of 431 women had a natural conception within 1 year. The primary outcome occurred in 8/227 (3.5%) women receiving 4.0 mg FA and 9/204 (4.4%) women receiving 0.4 mg FA (RR 0.80; 95%CI 0.31 to 2.03). The composite outcome occurred in 43/227 (18.9%) women receiving 4.0 mg FA and 75/204 (36.8%) women receiving 0.4 mg FA (RR 0.51; 95%CI 0.40 to 0.68). FA 4.0 mg supplementation was not associated with different occurrence of CMs, compared to FA 0.4 mg supplementation. However, FA 4.0 mg supplementation was associated with lower occurrence of other adverse pregnancy outcomes.
... Immigrant women from Ethiopia appears to have a higher prevalence of vitamin D deficiency (22) as well as a lower prevalence of folic acid supplement use than other immigrants (23). Both these factors have previously been linked to placental vascular pathology (24)(25)(26). ...
... Recent studies have shown that periconceptional intake of FA improves pregnancy outcomes specifically by preventing miscarriage, premature birth, pregnancy hypertension syndrome, postpartum depression, and autism in the offspring [15][16][17][18][19][20]. ...
Objectives: Neural tube defects (NTDs) are major congenital anomalies. To establish new and effective strategies to prevent these defects, public-private partnerships (PPPs) were formed between a healthcare company in Japan and numerous local governments to create educational activities regarding the importance of folic acid supplementation.
Methods: Projects for promoting maternal and child health using healthcare products and services created by a healthcare company were proposed to local governments as PPPs.
Results: Nine municipalities distributed folic acid supplements together with a Mother and Child Handbook while seven municipalities conducted surveys to identify people's knowledge and behavior toward folic acid use.
Conclusions: Recent studies have shown that periconceptional folic acid use improves many pregnancy outcomes; therefore, establishing educational activities regarding the importance of folic acid supplementation through PPPs is a rational and effective measure to promote maternal and child health.
