Table 11 Impact of peri-conceptional folic acid supplementation on stillbirth and perinatal mortality
From: Reducing stillbirths: behavioural and nutritional interventions before and during pregnancy
Source | Location and Type of Study | Intervention | Stillbirths/Perinatal Outcomes |
|---|---|---|---|
Reviews & meta-analyses | |||
Lumley et al. 2001 [84] | Hungary, Ireland, United Kingdom, Israel, Australia, Canada, the former USSR, and France. Meta-analysis (Cochrane). 3 RCTs included (N = 7,600 women). | Assessed the effects of increased consumption of folate (intervention) or multivitamins (controls) on the prevalence of neural tube defects peri-conceptionally. | SBR: RR = 0.78 (95% CI: 0.34–1.78) [NS] [13/3915 vs.16/3685 in intervention vs. control groups, respectively] |
Pena-Rosas and Viteri 2006 [86] | Ireland. Meta-analysis (Cochrane). 2 RCTs included (N = 145 participants). | Assessed the efficacy, effectiveness and safety of routine antenatal daily or intermittent iron supplementation with (intervention) or without (controls) folic acid during pregnancy on the health of mothers and newborns. | PMR: RR = 2.50 (95% CI: 0.10, 59.88) [NS] [1/77 vs. 0/68 in intervention vs. control groups, respectively] |
Rumbold et al. 2005 [87]. | India, Hungary, United Kingdom, Israel, Australia, Canada, the former USSR, France, Ireland, Nigeria, Nepal. Meta-analysis (Cochrane). 6 RCTs included. | Determined the effectiveness and safety of periconceptual/antenatal folic acid supplementation + multivitamin (intervention), as compared to no folic acid/multivitamin (controls) on the risk of spontaneous miscarriage, maternal adverse outcomes and fetal and infant adverse outcomes. | SBR: RR = 1.03 (95% CI: 0.51–2.09) [NS] [16/3511 vs. 15/3372 in intervention vs. control groups, respectively] |
Observational studies | |||
Persad et al. 2002 [125] | Canada (Nova Scotia). Birth registry data. Population-based retrospective study (before-after comparison). Included births and stillbirths with open NTDs that occurred from 1991–2000 in the Nova Scotia Atlee Perinatal Database. | Assessed the impact on NTDs after the Canadian government fortified grain products with folic acid. | Open NTDs: RR = 0.46 (95% CI: 0.32–0.66, P < 0.001) Anencephaly: RR = 0.41 (95% CI: 0.22–0.77, P = 0.004) [0.93/1000 before vs. 0.38/1000 births after intervention] |