The effect of long and short-term use of folate supplementation on shunt revision and spina bifida in demographically matched pregnant women: A cross-sectional clinical study

Abstract

IntroductionNewborn defects are one of the leading causes of admission to the pediatric service. The incidence of neural tube defects (NTD) increases with folate deficiency in pregnant women. This study focuses on folate supplementation and its postpartum effects. Materials and methodsThis cross-sectional study was designed to assess neural tube defect-related risks in data-matched pregnancies in terms of Folate supplementation. ResultsFolate supplementation at ≥3 months pregnancy had a 10 times higher protectivity against Tethered Cord Syndrome (TCS) than pregnancies without folate supplementation (p = 0,028; Odds ratios [OR] = 10.2). However, folate supplementation provided between 0 and 2 months of pregnancy did not differ from pregnant women who did not receive folate supplementation (p = 0,887). Compared to pregnant women without folate supplementation, pregnant women with folate supplementation at ≥3 months did not have higher protectivity against Spina Bifida, yet pregnant women with folate supplementation between 0 and 2 months did provide 19 times more protection against Spina Bifida (p = 0,023; OR = 19,444). Although there was no difference between not using folate supplementation during pregnancy or using it for less than 3 months (p = 0,491) in the protection against shunt revisions, the risk of shunt revisions increased 4 times if it was used for greater than 3 months during pregnancy (p = 0,018; OR = 4,03). ConclusionThe probability of shunt revision increased 4 times if folate was used for more than 3 months during pregnancy. Folate supplementation for only short periods of time protects against Spina bifida while long-term folate supplementation provides highly effective protection for TCS.