Folic Acid and Length of Time Between Pregnancies

Byron's Comments:

Folic acid keeps a mom healthy and helps her keep up with the demand of multiple pregnancies. If lacking in folate her children are more likely to be lower in birth weight (malnourished).

Study Title:

Association between short interpregnancy intervals and term birth weight: the role of folate depletion

Study Abstract:

Background: Maternal folate depletion has been proposed as a primary explanation for the excess risk of fetal growth restriction associated with short interpregnancy intervals.

Objective: We aimed to evaluate the folate depletion hypothesis in a community-based cohort of pregnant women.

Design: Using a subsample of the cohort (multiparous participants who delivered a liveborn singleton infant, n = 3153), we investigated the relation between an increase in the interpregnancy interval (from 1 to 24 mo, natural log transformation) and birth weight and the risk of small-for-gestational-age (SGA) in 3 strata of maternal periconceptional folic acid use: nonuse, late use (begun after conception), and early use (begun before conception).

Results: Each increase in the interpregnancy interval on the natural log (ln) scale was associated with a mean (±SE) increase of 63.1 ± 20.3 g in birth weight (P = 0.002). This relation was mitigated by folic acid use: the change in birth weight was increases of 165.2 ± 39.6 g for nonuse (P < 0.001) and 33.5 ± 35.6 g for late use (P = 0.347) and a decrease of 5.9 ± 33.6 g for early use (P = 0.861). The birth weight differences were directly translated into SGA risk. Odds ratios per 1-mo increase in ln(interpregnancy interval) were significant for the total group (0.61; 95% CI: 0.46, 0.82) and for nonuse (0.38; 0.24, 0.60) and nonsignificant for late (0.83; 0.48, 1.44) and early (1.28; 0.58, 2.84) use.

Conclusions: Folate depletion apparently contributes to the excess risk of fetal growth restriction that is associated with short interpregnancy intervals. As a preventive option, postnatal supplementation may be beneficial, but confirmation is needed

Study Information:

Manon van Eijsden, Luc JM Smits, Marcel F van der Wal and Gouke J Bonsel Association between short interpregnancy intervals and term birth weight: the role of folate depletion American Journal of Clinical Nutrition. 2008 July Vol. 88, No. 1, 147-153.
Department of Epidemiology, Documentation and Health Promotion, Municipal Health Service, Amsterdam, Netherlands.

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