The effect of folic acid throughout pregnancy among pregnant women at high risk of pre-eclampsia: A randomized clinical trial.

Abstract

Pre-eclampsia is a serious hypertension disease that occurs during pregnancy. Folic acid (FA) supplementation has been reported to reduce pre-eclampsia risk in pregnant women. Here, we aimed to assess whether treatment of high doses of FA in pregnant women with high pre-eclampsia risk could prevent the onset of pre-eclampsia. We conducted a randomized clinical trial in 1576 women who had pre-eclampsia or eclampsia in their last pregnancy and had a pregnancy plan. Subjects were randomized into two groups. The low dose (LD) group (n=788) received 0.4mg of FA daily from the first 3months of pregnancy until the entire pregnancy, and the high dose (HD) group (n=788) received 4mg of FA per day. We followed up the subjects until production. The plasma homocysteine (homocysteine) and FA levels were significantly higher in the HD group that in the LD group. Severe gestational hypertension, early onset pre-eclampsia (<32weeks' gestation), severe pre-eclampsia, and newborns' Apgar score <7 at 5min were remarkably decreased in the HD group compared with the LD group. Further, the incidence of pre-eclampsia was reduced in the HD group with compliance >50%. This study has provided evidence that a high dosage of FA supplement from 3months before pregnancy until the entire pregnancy reduces the recurrent pre-eclampsia.