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Preconception folic acid supplementation use and the occurrence of neural tube defects in Japan: A nationwide birth cohort study of the Japan Environment and Children's Study
Author(s) -
Nishigori Hidekazu,
Obara Taku,
Nishigori Toshie,
Ishikuro Mami,
Sakurai Kasumi,
Hoshiai Tetsuro,
Saito Masatoshi,
Fujiwara Ikuma,
Arima Takahiro,
Nakai Kunihiko,
Kuriyama Shinichi,
Mano Nariyasu,
Metoki Hirohito,
Yaegashi Nobuo
Publication year - 2019
Publication title -
congenital anomalies
Language(s) - English
Resource type - Journals
eISSN - 1741-4520
pISSN - 0914-3505
DOI - 10.1111/cga.12293
Subject(s) - anencephaly , medicine , spina bifida , offspring , encephalocele , odds ratio , neural tube , confidence interval , folic acid , pregnancy , neural tube defect , obstetrics , prospective cohort study , cohort study , cohort , pediatrics , fetus , surgery , biology , embryo , genetics , microbiology and biotechnology
We evaluated the relationship between preconception folic acid supplementation and the occurrence of neural tube defects (NTDs) in offspring, using data from the Japan Environment and Children's Study (a nationwide prospective birth cohort study) database. Of 92 269 participants with single pregnancies, 74 cases (offspring or fetuses) had NTDs, including 32 cases of spina bifida, 24 cases of anencephaly, and 19 cases of encephalocele. A total of 7634 participants (8.27%) used preconception folic acid supplementation, and of these, 621 (0.67%) also took in dietary folic acid at ≥480 μg/day. Multivariate logistic regression analyses demonstrated no association between preconception folic acid supplementation and NTDs in offspring or fetuses (odds ratio [OR] 0.622; 95% confidence interval [CI]: 0.226‐1.713). Moreover, the participants who combined preconception folic acid supplement use with dietary folic acid intake ≥480 μg/day demonstrated no incidence of NTDs in offspring or fetuses. Our analysis is limited by the absence of the data on the daily amount of supplementary folic acid intake, requiring careful attention to the interpretation. Additional surveys are required in Japan to resolve those limitations for further comprehensive assessment.