The association of maternal dietary folate intake and folic acid supplementation with small-for-gestational-age births: A cross-sectional study in Northwest China

  • Shanshan Li
  • , Danmeng Liu
  • , Ruo Zhang
  • , Fangliang Lei
  • , Xin Liu
  • , Yue Cheng
  • , Chao Li
  • , Mengyao Xiao
  • , Leqian Guo
  • , Minmin Li
  • , Binyan Zhang
  • , Zhonghai Zhu
  • , Guoshuai Shi
  • , Yezhou Liu
  • , Shaonong Dang
  • , Hong Yan

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

The effect of maternal folate intake on small-for-gestational-age (SGA) births remains inconclusive. The present study aimed to investigate the associations of maternal folate intake from diet and supplements with the risk of SGA births using data from a cross-sectional study in Shaanxi Province of Northwest China. A total of 7307 women who were within 12 months (median 3; 10th-90th percentile 0-7) after delivery were included. Two-level models were adopted to examine the associations of folate (dietary folate, supplemental folic acid and total folate) intake with the risk of SGA births and birth weight Z score, controlling for a minimum set of confounders that were identified in a directed acyclic graph. Results showed that a higher supplemental folic acid intake during the first trimester was negatively associated with the risk of SGA births (≤60 d v. non-use: OR 0·80; 95 % CI 0·66, 0·96; >60 d v. non-use: OR 0·78; 95 % CI 0·65, 0·94; Ptrend = 0·010; per 10-d increase: OR 0·97; 95 % CI 0·95, 0·99). A higher total folate intake during pregnancy was associated with a reduced risk of SGA births (highest tertile v. lowest tertile: OR 0·77; 95 % CI 0·64, 0·94; Ptrend = 0·010; per one-unit increase in the log-transformed value: OR 0·81; 95 % CI 0·69, 0·95). A similar pattern was observed for the birth weight Z score. Our study suggested that folic acid supplementation during the first trimester and a higher total folate intake during pregnancy were associated with a reduced risk of SGA births.

Original languageEnglish
Pages (from-to)459-467
Number of pages9
JournalBritish Journal of Nutrition
Volume122
Issue number4
DOIs
StatePublished - 28 Aug 2019

Keywords

  • Dietary folate
  • Folic acid supplements
  • Pregnancy
  • Small-for-gestational-age births

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