Association between Folate Levels and Preterm Birth in Tampa, Florida

• Main Author: Heeraman, Carolyn
• Format: Others
• Published: Scholar Commons 2016
• Subjects: B12; folic acid; imputation; MCMC; supplementation; logistic; Epidemiology; Nutrition; Public Health
• Online Access: http://scholarcommons.usf.edu/etd/6511; http://scholarcommons.usf.edu/cgi/viewcontent.cgi?article=7708&context=etd

Background: Preterm birth is one of the leading causes of perinatal mortality and morbidity and poses extensive economic liability. The rate of preterm births globally is approximately 11.1%, and in the US, the preterm birth rate has been estimated to be 12-13%. Folate and B12 requirements increase during pregnancy as a result of increased cell division to accommodate maternal and fetal growth; inadequate levels can result in placental abnormalities and thus present implications for preterm birth. Objective: To investigate the association between red blood cell (RBC) folate and B12 concentrations with the risk of preterm birth. Methods: Study participants were recruited from Tampa General Hospital between January 2011 and May 2013. Women with a singleton delivery occurring less than 37 weeks gestation were classified as cases and those with a singleton delivery occurring between 37 and 42 weeks gestation were classified as controls. The study had a final sample size of 227 women, including 36 cases and 191 controls. Maternal blood was collected in order to measure folate and B12 concentrations. The association between folate/B12 and preterm birth was assessed using logistic regression; odds ratio (OR), 95% confidence interval (CI) and p values are reported. A power analysis was also performed using the available sample as well as imputation for missing values in the B12 variable. Results: Although not statistically significant, the mean concentration of folate and B12 levels were higher in the cases than in the controls, 894 ± 158.1 vs. 869.2 ± 169.6 and 245.2 ± 102.2 vs 238.3 ± 81.5, respectively. No significant associations were found between folate or B12 and the risk of preterm birth. Conclusions: This study did not detect a significant association between folate or B12 and preterm birth; however, due to the small sample size this analysis was underpowered. Additional studies are needed, preferably using a randomized control study design, in order to elucidate the relationship between folate/B12 and preterm births.