Periconceptional intake of vitamins and fetal death: A cohort study on multivitamins and folate

摘要

Because fetal development requires energy and micronutrients, periconceptional use of multivitamins may be beneficial. Supplementation with folate has been recommended before and early in pregnancy to decrease the risk for neural tube defects, but the use of periconceptional multivitamins is controversial. Data from the Danish National Birth Cohort were used to examine the association between periconceptional multivitamin or folate-only use and risk for early and late fetal death. The Danish National Birth Cohort maintains data on 100,419 pregnancies in 92,374 women recruited in 1996 to 2002. The final study cohort comprised 35,914 pregnancies in 35,172 women. Women reported on supplement use by type and frequency during a 12-week periconceptional period, divided into a 6-week preconception and a 6-week postconception period and categorized as weeks 1 to 2, 3 to 4, and 5 to 6 relative to the two 6-week periods. Different patterns of multivitamin use were based on no, partial (1-3 weeks), or regular use (4-6 weeks) in either 6-week period. The associations between periconceptional multivitamin or folate use and early (<20 weeks) and late (>20 weeks) fetal death were estimated by hazard ratios (HRs) with 95% confidence intervals (CIs). Comparisons were made between supplement use or not at any time during the periconceptional period.