Maternal Folic Acid Supplement Use, Folate Intake, and Preterm Birth Among Infants With Spina Bifida

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Nutritional Science

Background:

• Spina bifida is a severe birth defect with significant implications for infant health.
• Folic acid supplementation is known to reduce the risk of neural tube defects like spina bifida.
• The association between folate intake and preterm birth in spina bifida pregnancies requires further investigation.

Purpose of the Study:

• To assess the relationship between folic acid supplementation, dietary folate intake, and preterm delivery in infants diagnosed with spina bifida.
• To identify specific maternal nutritional factors that may influence pregnancy outcomes in spina bifida cases.

Main Methods:

• Retrospective population-based study utilizing data from the National Birth Defects Prevention Study (NBDPS) and the Birth Defects Study To Evaluate Pregnancy exposureS (BD-STEPS).
• Analysis included 1199 infants with spina bifida.
• Robust Poisson regression was used to calculate risk ratios (RR) and 95% confidence intervals (CI) for preterm birth based on maternal folate status.

Main Results:

• Among 1199 infants with spina bifida, 18.1% were born preterm.
• No significant association was found between preterm birth and lack of folic acid supplementation alone or dietary folate intake quartiles alone.
• A combination of no folic acid supplementation and low dietary folate intake showed the strongest association with preterm birth (RR 1.73, 95% CI: 1.01-2.96).

Conclusions:

• A combination of no folic acid supplementation and low dietary folate intake is associated with a modestly elevated risk of preterm birth in infants with spina bifida.
• Further research is warranted to confirm these findings and explore the impact of supplementation timing.
• Low folate intake may be a contributing risk factor for preterm birth in pregnancies affected by spina bifida.