Association of Folic Acid Supplementation During Pregnancy and Infant Bronchiolitis

作者：Veeranki Sreenivas P; Gebretsadik Tebeb; Dorris Stacy L; Mitchel Edward F; Hartert Tina V; Cooper William O; Tylavsky Frances A; Dupont William; Hartman Terryl J; Carroll Kecia N^*

来源：American Journal of Epidemiology, 2014, 179(8): 938-946.

DOI：10.1093/aje/kwu019

• bronchiolitis
• folate
• folic acid supplementation
• Medicaid
• pregnancy
• prenatal vitamin

Viral bronchiolitis affects 2030 of infants; because there is no known effective treatment, it is important to identify risk factors that contribute to its pathogenesis. Although adequate folate intake during the periconceptional period prevents neural tube defects, animal data suggest that higher supplementation may be a risk factor for child respiratory diseases. Using a population-based retrospective cohort of 167,333 women and infants, born in 19952007 and enrolled in the Tennessee Medicaid program, we investigated the association between the filling of folic acidcontaining prescriptions and infant bronchiolitis. We categorized women into the following 4 groups in relation to the first trimester: none (no prescription filled), first trimester only, after first trimester, and both (prescriptions filled both during and after the first trimester). Overall, 21 of infants had a bronchiolitis diagnosis, and 5 were hospitalized. Most women filled their first prescriptions after the fifth to sixth weeks of pregnancy, and most prescriptions contained 1,000 g of folic acid. Compared with infants born to women in the none group, infants born to women in the first trimester only group had higher relative odds of bronchiolitis diagnosis (adjusted odds ratio 1.17, 95 confidence interval: 1.11, 1.22) and greater severity (adjusted odds ratio 1.16, 95 confidence interval: 1.11, 1.22). This studys findings contribute to an understanding of the implications of prenatal nutritional supplement recommendations for infant bronchiolitis.

• 出版日期2014-4-15