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Meta-Analysis
. 2020 Jan;16(1):e12895.
doi: 10.1111/mcn.12895. Epub 2019 Nov 4.

Maternal folic acid supplementation and infant birthweight in low- and middle-income countries: A systematic review

Hannah Jonker  1   2 , Noa Capelle  1 , Andrea Lanes  1 , Shi Wu Wen  1   3   4 , Mark Walker  1   3   4 , Daniel J Corsi  1   3   5
Affiliations
Meta-Analysis

Maternal folic acid supplementation and infant birthweight in low- and middle-income countries: A systematic review

Hannah Jonker et al. Matern Child Nutr. 2020 Jan.

Erratum in

  • CORRIGENDUM.
    [No authors listed] [No authors listed] Matern Child Nutr. 2021 Jul;17(3):e13193. doi: 10.1111/mcn.13193. Epub 2021 Apr 13. Matern Child Nutr. 2021. PMID: 34106527 Free PMC article. No abstract available.

Abstract

The relationship between maternal folic acid supplementation in pregnancy and infant birthweight has not been well described in low- and middle-income countries. We conducted a systematic review and meta-analysis of the current evidence of the association between folic acid supplementation in pregnancy on three primary outcomes: the incidence of low birthweight, small for gestational age, and mean birthweight. Seventeen studies were identified, which satisfied the inclusion criteria, covering a total of 275,421 women from 13 cohort studies and four randomized controlled trials. For the primary outcome of mean birthweight (n = 9), the pooled mean difference between folic acid and control groups was 0.37 kg (95% confidence interval [CI]: 0.24 to 0.50), and this effect was larger in the randomized controlled trials (0.56, 95% CI: 0.15 to 0.97, n = 3). The pooled odds ratio was 0.59 for low birthweight (95% CI: 0.47 to 0.74, n = 10) among folic acid supplementation versus control. The pooled odds ratio for the association with small for gestational age was 0.63 (95% CI: 0.39 to 1.01, n = 5). Maternal folic acid supplementation in low- and middle-income countries was associated with an increased mean birthweight of infants and decreases in the incidence of low birthweight and small for gestational age.

Keywords: birthweight; developing countries; folic acid; infant; nutritional status; pregnancy; systematic review.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Systematic review study selection process
Figure 2
Figure 2
Forest plot meta‐analysis of the mean birthweight in study groups supplemented with folic acid versus control groups
Figure 3
Figure 3
Funnel plot of the pooled mean difference for birthweights for study groups versus controls
Figure 4
Figure 4
Forest plot meta‐analysis of the incidence of low birthweight in study groups supplemented with folic acid versus control groups
Figure 5
Figure 5
Funnel plot of the odd ratios for low birthweight for study groups versus controls
Figure 6
Figure 6
Forest plot meta‐analysis of the incidence of small for gestational age in study groups supplemented with folic acid versus control groups
Figure 7
Figure 7
Forest plot meta‐analysis of the incidence of small for gestational age in study groups supplemented with folic acid versus control groups (Zheng, 2016, postconceptional use removed)
See this image and copyright information in PMC

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