ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2008
Maternal exposure to folic acid antagonists and placenta-mediated adverse pregnancy outcomes.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 70 citations in OpenAlex.
- Safety of Antimicrobials During Pregnancy: A Systematic Review of Antimicrobials Considered for Treatment and Postexposure Prophylaxis of Plague.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Pooled it
- Maternal exposure to sulfonamides and adverse pregnancy outcomes: A systematic review and meta-analysis.PloS one · 2020Pooled it
- Safety of cotrimoxazole in pregnancy: a systematic review and meta-analysis.Journal of acquired immune deficiency syndromes (1999) · 2014Pooled it
- Effect of high dose folic acid supplementation in pregnancy on pre-eclampsia (FACT): double blind, phase III, randomised controlled, international, multicentre trial.BMJ (Clinical research ed.) · 2018Trial
- Prevention of congenital malformations and other adverse pregnancy outcomes with 4.0 mg of folic acid: community-based randomized clinical trial in Italy and the Netherlands.BMC pregnancy and childbirth · 2014Trial
- Effect of folic acid supplementation in pregnancy on preeclampsia: the folic acid clinical trial study.Journal of pregnancy · 2013Trial
- Folic acid ameliorates placental structure and function in fetal growth restriction via epigenetic modifications.Clinical epigenetics · 2025Article
- Development of a quantitative prediction algorithm for human cord blood-derived CD34Scientific reports · 2024Article
- Epigenetic Genome Modifications during Pregnancy: The Impact of Essential Nutritional Supplements on DNA Methylation.Nutrients · 2024Review
- Article
- Factors Associated with Neural Tube Defects among Women Who Gave Birth at Adama Hospital Medical College, Adama, Ethiopia: A Case Control Study.Ethiopian journal of health sciences · 2023Article
- Biological Role of Folic Acid in Pregnancy and Possible Therapeutic Application for the Prevention of Preeclampsia.Biomedicines · 2023Review
- First trimester mechanisms of gestational sac placental and foetal teratogenicity: a framework for birth cohort studies.Human reproduction update · 2021Review
- Disruption of Folate Metabolism Causes Poor Alignment and Spacing of Mouse Conceptuses for Multiple Generations.Frontiers in cell and developmental biology · 2021Article
- Preventive effects of folic acid on Zika virus-associated poor pregnancy outcomes in immunocompromised mice.PLoS pathogens · 2020Article
- Nutraceuticals and Hypertensive Disorders in Pregnancy: The Available Clinical Evidence.Nutrients · 2020Review
- Preparing for biological threats: Addressing the needs of pregnant women.Birth defects research · 2017Review
- Evaluation of the effect of high-dose folic acid on endothelial dysfunction in pre-eclamptic patients: A randomized clinical trial.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2016Article
- Folic Acid Supplementation in Pregnancy and the Risk of Pre-Eclampsia-A Cohort Study.PloS one · 2016Article
- Article
Corrections and comments
- Commented on by
Authors and funding
6 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn previous studies, maternal exposure to folic acid antagonists was associated with increased risks of neural tube defects, cardiovascular defects, oral clefts and urinary tract defects. The objective of the current study was to assess the possible effects of using folic acid antagonists in pregnancy on placenta-mediated adverse outcomes of pregnancy.
methodsWe used data from an administrative database to retrospectively compare the occurrence of placenta-mediated adverse pregnancy outcomes between pregnant women exposed to folic acid antagonists and women without exposure to these agents.
resultsWe included in the analysis a total of 14 982 women who had been exposed to folic acid antagonists and 59 825 women who had not been exposed. Sulfamethoxazole-trimethoprim was the most frequently prescribed dihydrofolate reductase inhibitor (a total of 12 546 exposures during the preconception period and all 3 trimesters), and phenobarbital was the most frequently prescribed among the other folic acid antagonists (a total of 1565 exposures). The risks of preeclampsia (adjusted odds ratio [OR] 1.52, 95% confidence interval [CI] 1.39-1.66), severe preeclampsia (OR 1.77, 95% CI 1.38-2.28), placental abruption (OR 1.32, 95% CI 1.12-1.57), fetal growth restriction defined as less than the 10th percentile (OR 1.07, 95% CI 1.01-1.13), fetal growth restriction defined as less than the 3rd percentile (OR 1.22, 95% CI 1.11-1.34) and fetal death (OR 1.35, 95% CI 1.07-1.70) were greater among mothers with exposure to folic acid antagonists. In general, the risks associated with exposure to other folic acid antagonists were higher than those associated with exposure to dihydrofolate reductase inhibitors. Supplementary analyses involving tight matching with propensity score, restriction of the analysis to women with exposure during the first and second trimesters and restriction of the analysis to specific categories of folic acid antagonists yielded similar results.
interpretationMaternal exposure to folic acid antagonists appears to increase the risk of placenta-mediated adverse outcomes of pregnancy.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.