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High-dose folic acid supplements fail to prevent preeclampsia
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Taking 4 mg of folic acid or more after the first trimester did not prevent preeclampsia among pregnant women at high risk for the condition, according to findings recently published in BMJ.
“Previous studies have been observational in nature and thus warranted a large randomized controlled trial,” Shi Wu Wen, MB, PhD, professor of clinical epidemiology at the Ottawa Hospital Research Institute in Canada and colleagues wrote.
Researchers randomly assigned women in five countries who were no more than 16 weeks pregnant and with at least one risk factor for preeclampsia to receive either 4 mg of folic acid (n = 1,144) or placebo (n = 1,157) daily until they delivered.
Though Wen and colleagues reported that preeclampsia occurred at similar rates between the groups — 14.8% in the folic acid group and 13.5% in the placebo group (RR = 1.1; 95% CI, 0.9- 1.34) — they stressed that women in preconception and early pregnancy should still take folic acid supplements.
The importance of folic acid was echoed by Jenny E. Myers, PhD, MRCOG, a clinical senior lecturer at the University of Manchester in the United Kingdom and colleagues in a related editorial.
“Recommendation of low-dose folic acid supplementation before pregnancy and in the first trimester must continue for prevention of neural tube defects,” they wrote.
Wen, et al, suggested future research address when folic acid supplement consumption by pregnant women should cease.
“There is a need to define when to discontinue supplementation as current clinical practice guidelines do not provide clear guidance beyond the first trimester,” they wrote. – by Janel Miller
Disclosures : None of the authors report any relevant financial disclosures.