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Published on: June 28, 2024
Periconceptional folic acid supplementation is a risk factor for childhood asthma: a case-control study
Shuyuan Chu1,2, Jun Zhang3
1Laboratory of Respiratory Disease, Affiliated Hospital of Guilin Medical University, Guilin, 541001, China. emilyyuanchu@163.com.
Insights
Periconceptional folic acid supplementation may increase childhood asthma risk. This finding suggests a need for further research into the timing and duration of supplementation to understand its impact on asthma development.
Area of Science:
- Environmental Health
- Pediatric Allergy
- Reproductive Health
Background:
- Inconsistent evidence links folic acid to childhood asthma risk.
- Biological mechanisms underlying this association are unclear.
Purpose of the Study:
- Investigate the association between periconceptional folic acid supplementation and childhood asthma risk.
- Explore the impact of supplementation timing and duration.
Main Methods:
- Hospital-based case-control study in Shanghai, China.
- 548 childhood asthma cases and 816 controls.
- Mothers interviewed regarding folic acid intake; unconditional logistic regression used.
Main Results:
- Periconceptional folic acid supplementation showed an increased risk of childhood asthma (aOR=1.28).
- Risk was higher when supplementation started before gestation (aOR=1.31) and after the first month (aOR=1.90).
- Supplementation exceeding 6 months was associated with the highest risk (aOR=1.75).
Conclusions:
- Periconceptional folic acid supplementation is linked to increased childhood asthma risk.
- Further research is essential to clarify this association and its implications.
Background:
Several studies found an association between periconceptional folic acid supplementation and the risk of childhood asthma. But the epidemiologic evidence is still inconsistent and the underlying biological mechanisms remain unclear.
Methods:
We conducted a hospital-based case-control study on childhood asthma with 548 cases and 816 normal controls in Shanghai, China. Mothers of the asthma children were asked about folic acid supplementation before and during pregnancy. Unconditional logistic regression models were employed to control for potential confounders.
Results:
Periconceptional folic acid supplementation was associated with an increased risk of childhood asthma after adjusting for potential confounders (adjusted OR = 1.28 [95% CI 1.14-1.43]). Moreover, the adjusted OR varied by the timing of starting folic acid supplementation: before gestation: 1.31 [95% CI 1.01-1.70]; in the 1st month of gestation: 1.09 [95% CI 0.96-1.23]; and after the 1st month of gestation: 1.90 [95% CI 1.56-2.30]. We further found that the adjusted OR was the highest when periconceptional folic acid supplementation lasted more than 6 months (< 4 months: 1.21 [95% CI 1.07-1.37]; 4-6 months: 1.06 [95% CI 0.88-1.27]; > 6 months: 1.75 [95% CI 1.35-2.27]).
Conclusions:
Periconceptional folic acid supplementation was associated with an increased risk of childhood asthma in offspring. Further research on this issue is warranted.
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