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Maternal periconceptional folic acid supplementation and risk for fetal congenital genitourinary system defects

Pediatric Research volume 95, pages 1132–1138 (2024)Cite this article

Abstract

Background

Taking folic acid supplementation could reduce the risk of neural tube defects for offspring in the maternal periconceptional period, but the relationship between folic acid use and other birth defects remains unclear, such as genitourinary system birth defects.

Methods

The data from a Prenatal Health Care System and Birth Defects Surveillance System in Tongzhou, Beijing, China, were collected from 2013 to 2018. We adjusted for differences in characteristics between comparison groups using propensity score inverse probability weighting and assessed associations with Poisson regression modeling.

Results

A total of 65,418 live births and stillbirths were included, and there were 194 cases with congenital genitourinary defects among them. The prevalence of genitourinary system birth defects was 29.2 (34.9) per 10,000 for FA/MMFA users (nonusers). Compared to nonusers, FA/MMFA users had a lower risk for genitourinary system birth defects (adjusted risk ratio [aRR] 0.81, 95% confidence interval [CI] 0.67, 0.98), and for hypospadias (aRR 0.55, 95% CI 0.40, 0.76).

Conclusions

FA or MMFA supplementation during the maternal periconceptional period could reduce the risk for genitourinary system birth defects in offspring. More mechanisms should be explored for the protective effect.

Impact

  • Folic acid (FA) or multiple micronutrients containing folic acid (MMFA) supplementation during the maternal periconceptional period could reduce the risk for genitourinary system birth defects in offspring.

  • Maternal FA/MMFA supplementation during the periconceptional period may reduce the risk for hypospadias.

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Fig. 1: The analysis tree.

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Data availability

The datasets generated during and analyzed during the current study are available from the corresponding author upon reasonable request.

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Funding

This study was supported by the National Key R&D Program of China, 2021YFC2701000 and 2021YFC2701001.

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China

    Zixi Pang, Jie Zhang, Di Wang & Lei Jin

  2. Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, 100191, China

    Zixi Pang, Jie Zhang, Di Wang & Lei Jin

  3. Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, 101100, China

    Lei Jin & Wenying Meng

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  1. Zixi Pang
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Contributions

L.J. and Z.P. conceptualized and designed the study, drafted the manuscript, performed the analysis and revised the manuscript critically for important intellectual content. L.J., J.Z. and W.M. contributed to the acquisition and interpretation of data and revised it critically for important intellectual content. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.

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Correspondence to Lei Jin.

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This study was approved by the biomedical ethics committee of Peking University (no. IRB00001052-18010). Informed consent of all participants is exempted.

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Pang, Z., Jin, L., Zhang, J. et al. Maternal periconceptional folic acid supplementation and risk for fetal congenital genitourinary system defects. Pediatr Res 95, 1132–1138 (2024). https://doi.org/10.1038/s41390-023-02808-7

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