Folate Supplementation May Reduce Premature Delivery

According to the latest data from the National Center for Health Statistics babies born prematurely has risen to more than 12.5%, the highest level in two decades, and a more than 30% increase since 1981. In 2004, more than half a million babies were born prematurely in the United States. Babies born prematurely have less developed organs than full-term babies and are more likely to face serious multiple health problems following delivery. Premature babies often require extensive and expensive stays in a neonatal intensive care units, which has specialized medical staff and equipment. Finally, prematurity is the leading cause of newborn death–accounting for 25% of deaths in the first month of life.

Premature babies who survive may suffer lifelong consequences, including cerebral palsy, mental retardation, chronic lung disease, vision and hearing loss. While many of the underlying causes of preterm birth are not well known, the three risk factors most consistently identified by experts are: (1) multiple births–increased due to infertility treatments, (2) uterine and/or cervical abnormalities, and most importantly (3) a woman’s past history of preterm delivery. Other possible risk factors may include: chronic health problems, certain infections during pregnancy; and cigarette smoking, alcohol or illicit drug use during pregnancy.

Once preterm labor has begun we have minimally effective medications to stop it long-term. For the highest risk group of women who have a history of preterm labor weekly progesterone injections are now routinely administered prophylacticly beginning in the mid trimester.

While addressing socioeconomic issues can influences preterm delivery rates in high risk groups such as poor African American women, it is complex and requires extensive resources. In the recent FASTER trial women who reported taking folate supplementation for 1 year or more had a 70% decreased risk for preterm birth between 20 and 28 weeks of gestation, and a 50% decrease in risk of delivering between 28 and 32 weeks of gestation.

Nevertheless it seems wise for women even remotely considering pregnancy or those not using highly effective forms of contraception (e.g. condoms) to take a daily multivitamin. Folate has already been conclusively shown to reduce some neurologic and cardiac birth defects, and perhaps it may help with the largest cause of newborn complications, preterm delivery. For more information about planning your pregnancy please read this brochure in our online women’s health library.

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