Folic Acid Supplement Use and Increased Risk of Gestational Hypertension

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Nutritional Science

Background:

• Limited and inconsistent data exist on folic acid (FA) supplement effects on gestational hypertension (GH) and preeclampsia.
• Understanding FA's role is crucial for optimizing maternal and infant health outcomes.

Purpose of the Study:

• To investigate the association between folic acid (FA) supplement use and the incidence of gestational hypertension (GH) and preeclampsia.
• To clarify the impact of periconceptional and early pregnancy FA supplementation on hypertensive disorders of pregnancy.

Main Methods:

• A cohort study of 4853 women from the Tongji Maternal and Child Health Cohort.
• Robust Poisson regression analysis was employed to assess the association between FA supplement use and GH/preeclampsia.
• Adjustments were made for various demographic, lifestyle, and clinical factors.

Main Results:

• High-dose folic acid (≥800 µg/d) from prepregnancy through midpregnancy was associated with an increased risk of gestational hypertension (RR, 1.32; 95% CI, 1.06-1.64).
• This association persisted after adjusting for multiple confounding factors and in subgroup analyses.
• No significant association was found between FA supplement use and preeclampsia.

Conclusions:

• High-dose folic acid supplementation (≥800 µg/d) during the periconceptional and early pregnancy period is linked to an elevated risk of gestational hypertension.
• Caution is advised regarding high-dose FA intake to mitigate potential risks of GH in women planning or capable of pregnancy.