Maternal folic acid supplementation and more prominent birth weight gain in twin birth compared with singleton birth: a cross-sectional study in northwest China. Issue 16 (17th November 2020)

• Record Type: Journal Article
• Authors: Zhang, Binyan; Shang, Suhang; Li, Shanshan; Mi, Baibing; Li, Minmin; Shi, Guoshuai; Ma, Mao; Wang, Qian; Yan, Hong; Dang, Shaonong
• Is Part Of: Public health nutrition. Volume 23:Issue 16(2020)
• Page Start: 2973
• Page End: 2982
• Publication Date: 2020-11-17
• Subjects: Folic acid supplementation, -- Birth weight, -- Twins, -- Interaction effect; Nutrition -- Periodicals; Nutrition policy -- Periodicals; Public health -- Periodicals; 613.2
• DOI: 10.1017/S1368980019004580
• Languages: English
• ISSNs: 1368-9800

Abstract

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.