PMID- 34060120 OWN - NLM STAT- MEDLINE DCOM- 20211124 LR - 20211124 IS - 1365-3016 (Electronic) IS - 0269-5022 (Linking) VI - 35 IP - 6 DP - 2021 Nov TI - Maternal periconceptional folic acid supplements use and fetus risk for limb defects. PG - 645-653 LID - 10.1111/ppe.12775 [doi] AB - BACKGROUND: Associations between the periconceptional folic acid only (FAO) or multiple micronutrients containing folic acid (MMFA) supplementation and risk for limb defects are inconsistent. OBJECTIVE: To explore the association between periconceptional folic acid supplements use and risk for limb defects, including clubfoot, polydactyly, syndactyly, and limb deficiencies. METHODS: Data were derived from a cohort based on a pregnancy registry in a district of Beijing, China, from 2013 to 2018. Information on maternal periconceptional FAO and MMFA supplementation was collected via face-to-face interviews at first trimester. Pregnancy outcomes including limb defects were ascertained in livebirths, stillbirths, and elective pregnancy terminations and were recorded into the system. Propensity score methods were used to adjust for potential confounders. RESULTS: A total of 63 969 women with a singleton delivery were included. The overall prevalence of limb defects was 47.5 per 10 000 (n = 63 969) singleton deliveries. Decreased prevalence of limb defects was found among FAO/MMFA users compared with women who did not take supplements (nonusers) (46.1 vs. 61.9 per 10 000 births, adjusted risk ratio [RR] 0.80, 95% confidence interval [CI] 0.56, 1.12). Compared with nonusers (n = 6462, 10.2%), women who took either FAO (n = 26 567, 42.0%) or MMFA (n = 30 259, 47.8%) had a lower risk for total clubfoot (RR 0.40, 95% CI 0.20, 0.84), and for isolated clubfoot (RR 0.41, 95% CI 0.17, 0.97). For other limb defects except clubfoot, FAO supplementation did not appear to be associated with reduced risk, while MMFA supplementation group had 30%-50% reduced risks for other limb defects. A lower risk for limb defects or isolated limb defects was found with MMFA supplementation when FAO supplementation was used as a control. CONCLUSIONS: Maternal periconceptional supplements with either FAO or MMFA had inverse association with clubfoot in offspring, and MMFA was associated with lower risk for isolated limb defects compared with FAO. CI - (c) 2021 John Wiley & Sons Ltd. FAU - Zhang, Jie AU - Zhang J AD - Institute of Reproductive and Child Health, Peking University/ National Health Commission Key Laboratory, Peking University, Beijing, China. AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. FAU - Jin, Lei AU - Jin L AD - Tongzhou Maternal and Child Health Hospital, Beijing, China. FAU - Wang, Di AU - Wang D AD - Institute of Reproductive and Child Health, Peking University/ National Health Commission Key Laboratory, Peking University, Beijing, China. AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. FAU - Wang, Cheng AU - Wang C AD - Institute of Reproductive and Child Health, Peking University/ National Health Commission Key Laboratory, Peking University, Beijing, China. AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. FAU - Tong, Mingkun AU - Tong M AUID- ORCID: 0000-0001-6814-0390 AD - Institute of Reproductive and Child Health, Peking University/ National Health Commission Key Laboratory, Peking University, Beijing, China. AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. FAU - Yu, Jinhui AU - Yu J AD - Institute of Reproductive and Child Health, Peking University/ National Health Commission Key Laboratory, Peking University, Beijing, China. AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. FAU - Meng, Wenying AU - Meng W AD - Institute of Reproductive and Child Health, Peking University/ National Health Commission Key Laboratory, Peking University, Beijing, China. AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. FAU - Ren, Aiguo AU - Ren A AUID- ORCID: 0000-0001-9115-5638 AD - Institute of Reproductive and Child Health, Peking University/ National Health Commission Key Laboratory, Peking University, Beijing, China. AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. FAU - Jin, Lei AU - Jin L AD - Institute of Reproductive and Child Health, Peking University/ National Health Commission Key Laboratory, Peking University, Beijing, China. AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210531 PL - England TA - Paediatr Perinat Epidemiol JT - Paediatric and perinatal epidemiology JID - 8709766 RN - 935E97BOY8 (Folic Acid) SB - IM MH - Dietary Supplements MH - Female MH - Fetus MH - *Folic Acid MH - Humans MH - *Limb Deformities, Congenital/epidemiology/prevention & control MH - Pregnancy MH - Pregnancy Outcome OTO - NOTNLM OT - birth defect OT - cohort OT - folic acid OT - limb defect OT - multiple micronutrients EDAT- 2021/06/02 06:00 MHDA- 2021/11/25 06:00 CRDT- 2021/06/01 06:49 PHST- 2021/04/09 00:00 [revised] PHST- 2021/01/15 00:00 [received] PHST- 2021/04/18 00:00 [accepted] PHST- 2021/06/02 06:00 [pubmed] PHST- 2021/11/25 06:00 [medline] PHST- 2021/06/01 06:49 [entrez] AID - 10.1111/ppe.12775 [doi] PST - ppublish SO - Paediatr Perinat Epidemiol. 2021 Nov;35(6):645-653. doi: 10.1111/ppe.12775. Epub 2021 May 31.