American Journal of Epidemiology Advance Access published online on January 10, 2008
American Journal of Epidemiology, doi:10.1093/aje/kwm373
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Original Contribution |
Folic Acid and Multivitamin Supplement Use and Risk of Placental Abruption: A Population-based Registry Study
1 Section for Epidemiology and Medical Statistics, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
2 Medical Birth Registry of Norway, Norwegian Institute of Public Health, Bergen, Norway
3 Institute of Clinical Medicine, Department of Obstetrics and Gynecology, University of Bergen, Bergen, Norway
4 LOCUS for Homocysteine and Related Vitamins, and Section for Pharmacology, Institute of Medicine, University of Bergen and Haukeland University Hospital, Bergen, Norway
Correspondence to Roy Miodini Nilsen, Department of Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, N-5018 Bergen, Norway (e-mail: roy.nilsen{at}uib.no).
Received for publication August 5, 2007. Accepted for publication November 30, 2007.
The authors investigated a possible association of supplemental folic acid and multivitamin use with placental abruption by using data on 280,127 singleton deliveries recorded in 1999–2004 in the population-based Medical Birth Registry of Norway. Odds ratios, adjusted for maternal age, marital status, parity, smoking, pregestational diabetes, and chronic hypertension, were estimated with generalized estimating equations for logistic regression models. Use of folic acid and/or multivitamin supplements before or any time during pregnancy was reported for 36.4% of the abruptions (0.38% of deliveries) and 44.4% of the nonabruptions. Compared with no use, any supplement use was associated with a 26% risk reduction of placental abruption (adjusted odds ratio = 0.74, 95% confidence interval: 0.65, 0.84). Women who had taken folic acid alone had an adjusted odds ratio of 0.81 (95% confidence interval: 0.68, 0.98) for abruption, whereas multivitamin users had an adjusted odds ratio of 0.72 (95% confidence interval: 0.57, 0.91), relative to supplement nonusers. The strongest risk reduction was found for those who had taken both folic acid and multivitamin supplements (adjusted odds ratio = 0.68, 95% confidence interval: 0.56, 0.83). These data suggest that folic acid and other vitamin supplementation during pregnancy may be associated with reduced risk of placental abruption.
abruptio placentae; dietary supplements; folic acid; Norway; pregnancy; risk factors; vitamins
Abbreviations: CI, confidence interval; OR, odds ratio
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