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Folic acid improves outcomes of infants born to smoking mothers
Mothers who smoked during pregnancy improved the size of the fetus by taking higher doses of folic acid, according to the results of a randomized clinical trial published in JAMA Pediatrics.
“All pregnant women get folic acid during pregnancy at a specific dose,” Hamisu M. Salihu, MD, PhD, professor and vice chair of research in family and community medicine at Baylor College of Medicine, told Infectious Diseases in Children. “However, smokers need more folic acid for optimal fetal development because of relative deficiencies since tobacco smoke reduces the bioavailability and activity of normal folic acid metabolism.”
Pregnant women between the ages of 18 and 44 years who were active smokers were enrolled in the study and were randomly assigned to receive either 4 mg of folic acid daily (higher dose group) or 0.8 mg of folic acid daily (standard-dose group).
Of the infants born to 312 women who had available follow-up information and met inclusion criteria, 23.7% were born small for gestational age, and 29.2% were born with fetal growth restriction. The average birth weight for all infants was 3,059 g.
Women in the higher dose group had babies that weighed 140.39 g (95% CI, 1.63-279.15) more on average compared with infants in the standard group. Infants born to these mothers also had a 31% reduced risk for being small for gestational age (adjusted RR = 0.69; 95% CI, 0.46-1.03) and were 35% less likely to have fetal growth restriction (aRR = 0.65; 95% CI, 0.46-0.93).
The researchers observed no increased risk for adverse events related to higher dose folic acid use.
Salihu suggested that based on these findings, mothers who continue to smoke during pregnancy should be given a dose of folic acid that is at least five times the normal recommended dose. – by Katherine Bortz
Disclosures: The authors report no relevant financial disclosures.
