WHO Report on Preconception Care

A new WHO report shows that preconception care has a positive impact on maternal and child health outcomes.

Study on Maternal Periconceptional Supplementation

A new study by Dr. Di Wang, BM and team reported that maternal periconceptional supplementation with Folic Acid (FA) or Multiple Micronutrients with Folic Acid (MMFA) appears to reduce the risk for Congenital Heart Defects (CHDs), especially critical CHD, in offspring.

This study is published in The Journal of Pediatrics.

Objective of the Study

The objective of the study was to determine the effects of maternal periconceptional supplementation with FA or MMFA on the prevention of fetal congenital heart defects (CHDs).

Study Methodology

The study was a survey where the data was drawn from a Prenatal Health Care System and a Birth Defects Surveillance System in a district of Beijing, China. A total of 63,969 singleton births, live or stillborn, 308 CHDs among them, during 2013 to 2018 were included. Associations between different patterns of supplementation and risk for total CHDs or main types of CHDs were evaluated with risk ratios (RRs).

Results of the Study

• The survey found FA or MMFA users compared with nonusers, the adjusted risk ratios (ARRs) for total CHDs, critical CHD.
• Ventricular Septal Defect (VSD) were 0.60 (95% confidence interval [CI]: 0.44-0.83), 0.41 (95%CI: 0.26-0.67), and 0.47 (95%CI: 0.30-0.74).
• When compared MMFA users with FA users, they found the ARRs were 0.84 (95%CI: 0.66-1.09), 0.64 (95%CI: 0.41-1.00), and 0.94 (95%-CI: 0.63-1.41) for total CHDs, critical CHD, and VSD.
• Comparative survey with supplementation initiated after conception, supplementation initiated before conception was associated with a lower risk for CHDs: the ARRs were 0.68 (95%CI: 0.48-0.95) for total CHDs and 0.26 (95%CI: 0.10-0.71) for critical CHD but 1.08 (95%CI: 0.63-1.83) for VSD.

Conclusion

Dr. Wang and team concluded that "Maternal periconceptional supplementation with Folic Acid or MMFA appears to reduce the risk for Congenital Heart Defects (CHDs), especially critical CHD, in offspring." They also added that "Supplementation confers a greater protective effect when it is initiated before conception. We did not find any difference between FA and MMFA in terms of preventing CHDs."

For further information: https://doi.org/10.1016/j.jpeds.2021.09.004