Preeclampsia Clinical Trial
Official title:
Effect of Folic Acid Supplementation in Pregnancy on Preeclampsia-Folic Acid Clinical Trial (FACT)
To determine the efficacy of high dose folic acid supplementation for prevention of preeclampsia in women with at least one risk factor: pre-existing hypertension, pre-pregnancy diabetes (type 1 or 2), twin pregnancy, preeclampsia in a previous pregnancy, or body mass index ≥35. It was hypothesized that high dose (4.0 mg per day) supplementation starting in early pregnancy and continued throughout the entire pregnancy will lower the incidence of preeclampsia in pregnant women at high risk of developing preeclampsia.
Preeclampsia is a complication of pregnancy which affects at least 5% of all pregnancies
worldwide and has serious health consequences to these women and their babies. Preeclampsia
is hypertension (high blood pressure) in pregnancy with proteinuria. Proteinuria is when
protein is found in the urine, and it is a sign that the kidneys are not functioning
properly. The only effective treatment for preeclampsia is delivery of the baby. Because
delivery may be required before the anticipated date of delivery; preeclampsia is also one of
the leading causes of preterm delivery and accounts for 25% of very low birth weight infants.
Recent research has also shown that women who have had preeclampsia during pregnancy are more
likely to be at risk for future cardiovascular events later in life.
Recently some studies have shown that supplementation with multivitamins containing folic
acid is associated with a reduced risk of developing preeclampsia. These findings also
suggested that for the prevention of preeclampsia, a high dose of folic acid (much higher
than the amount of folate received from food intake or what is usually taken during
pregnancy) may be needed.
A randomized controlled trial was conducted in 70 obstetrical centres in 5 countries
(Argentina, Australia, Canada, Jamaica, and the UK) to evaluate the effect of high dose folic
acid started in early pregnancy on the risk of developing preeclampsia in high-risk women. A
sample size of 2464 allowed for 80% power and a 10% loss to follow-up/study withdrawal.
Participants received either placebo or four 1.0 mg oral tablets of folic acid.
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