Maternal folic acid supplementation and more prominent birth weight gain in twin birth compared with singleton birth: a cross-sectional study in northwest China

Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi 710061, People’s Republic of China

Suhang Shang

Affiliation:

The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, People’s Republic of China

Shanshan Li

Affiliation:

Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi 710061, People’s Republic of China

Baibing Mi

Affiliation:

Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi 710061, People’s Republic of China

Minmin Li

Affiliation:

Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi 710061, People’s Republic of China

Guoshuai Shi

Affiliation:

Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi 710061, People’s Republic of China

Mao Ma

Affiliation:

The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, People’s Republic of China

Qian Wang

Affiliation:

The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710004, People’s Republic of China

Hong Yan

Affiliation:

Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi 710061, People’s Republic of China Nutrition and Food Safety Engineering Research Center of Shaanxi Province, Xi’an, Shaanxi 710061, People’s Republic of China

Shaonong Dang

Affiliation:

Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi 710061, People’s Republic of China

Corresponding

E-mail address:

tjdshn@mail.xjtu.edu.cn ;

yanhonge@mail.xjtu.edu.cn

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Abstract
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Abstract

Objective:

To investigate the association of folic acid (FA) supplementation with birth weight, the risk of small for gestational age (SGA) and low birth weight (LBW) in singleton and twin pregnancy.

Design:

A population-based cross-sectional survey.

Setting:

Twenty counties and ten districts in Shaanxi Province of northwestern China, 2013.

Participants:

28 174 pregnant women with their infants, covering 27 818 single live births and 356 twin live births.

Results:

The prevalence of FA supplementation in singletons and twins was 63·9 and 66·3 %. The mean birth weight was 3267 (sd 459·1) g, 2525 (sd 534·0) g and 2494 (sd 539·5) g; the prevalence of SGA was 14·3, 51·4 and 53·4 %; the prevalence of LBW was 3·4, 42·4 and 46·6 % among singleton, twin A and twin B, respectively. Compared with non-users, women with FA supplementation were (β 17·3, 95 % CI 6·1, 28·4; β 166·3, 95 % CI 69·1, 263·5) associated with increased birth weight, lower risk of SGA (OR 0·85, 95 % CI 0·80, 0·92; OR 0·45, 95 % CI 0·30, 0·68) and LBW (OR 0·82, 95 % CI 0·71, 0·95; OR 0·50, 95 % CI 0·33, 0·75) in singletons and twins, and more prominent effects in twins. Moreover, there were significant interactions between FA supplementation and plurality on birth weight, SGA and LBW.

Conclusions:

The present study suggests the association of periconceptional 0·4 mg/d FA supplementation with increased birth weight and reduced risk of SGA and LBW in both singletons and twins, and this association may be more prominent in twins.

Keywords

Folic acid supplementation Birth weight Twins Interaction effect

Type

Research paper

Information

Public Health Nutrition , Volume 23 , Issue 16 , November 2020 , pp. 2973 - 2982

DOI: https://doi.org/10.1017/S1368980019004580

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Footnotes

†

S. Dang and H. Yan contributed equally to this work.

References

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Maternal folic acid supplementation and more prominent birth weight gain in twin birth compared with singleton birth: a cross-sectional study in northwest China

Abstract

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Zhang et al. Supplementary Materials

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