Association Between Use of Oral Contraceptives and Folate Status: A Systematic Review and Meta-Analysis
Mahvash Shere1, Priya Bapat2, Cheri Nickel3
1Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto ON; The Motherisk Program, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto ON.
Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'Obstetrique Et Gynecologie Du Canada : JOGC
|July 14, 2015
Summary
Oral contraceptive use significantly lowers blood folate levels in women. Continued folate supplementation is crucial for women of childbearing age using oral contraceptives to maintain adequate folate status.
Area of Science:
- Nutritional Biochemistry
- Reproductive Health
- Pharmacology
Background:
- Oral contraceptive (OC) use is widespread among women of reproductive age.
- Folate is essential for numerous metabolic processes, including DNA synthesis and repair.
- Suboptimal folate status can have significant health implications, particularly during pregnancy.
Purpose of the Study:
- To systematically review and meta-analyze the impact of oral contraceptive use on plasma and red blood cell (RBC) folate concentrations.
- To quantify the effect of oral contraceptives on folate status in women.
Main Methods:
- Comprehensive literature search of major scientific databases (Medline, EMBASE, Web of Science, Cochrane Library) up to June 2013.
- Inclusion of human studies including case-control, cohort studies, and clinical trials evaluating OC use and folate status.
- Application of a random-effects model for meta-analysis of pooled outcomes.
Main Results:
- Analysis of 17 studies involving 2831 women revealed a significant reduction in plasma folate concentrations (mean decrease of 1.27 µg/L).
- Data from 12 studies with 1389 women indicated a substantial decrease in RBC folate concentrations (mean decrease of 59.32 µg/L) among OC users.
- Both plasma and RBC folate levels were significantly lower in women using oral contraceptives.
Conclusions:
- Oral contraceptive use is associated with a significant reduction in both plasma and red blood cell folate levels.
- Women of childbearing age using oral contraceptives should continue folate supplementation.
- Maintaining adequate folate status is critical for women using oral contraceptives, especially for preventing neural tube defects in potential pregnancies.
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