scholarly journals Efficacy of Periconceptional High-Dose Folic Acid in Isolated Orofacial Cleft Prevention: A Systematic Review

2019 ◽  
Vol 52 (02) ◽  
pp. 153-159 ◽  
Author(s):  
Rajshree Jayarajan ◽  
Anantharajan Natarajan ◽  
Ravindranathan Nagamuttu
Keyword(s):  
Folic Acid ◽  
High Risk ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Meta Analysis ◽  
Strong Association ◽  
Folic Acid Supplementation ◽  
Case Control ◽  
High Dose ◽  
Case Control Studies

Abstract Background The effectiveness of folic acid in prevention of neural tube defects has been well established. Periconceptional supplementation of folic acid in low doses has been shown to be effective in some studies on its efficacy in prevention of occurrence of clefts. There are few studies on high-dose folic acid for prevention of occurrence and recurrence of clefts in high risk cases and the overall consensus based on these is not available. Objectives The aim of this review is to assess whether high-dose folic acid supplementation during the periconceptional period reduces the risk of occurrence of nonsyndromic clefts and recurrence in high-risk cases. Search Methods Search was conducted in the various databases and trial registers. There were no restrictions in the search with regards to language, study setting, or date of publication. Results The search yielded four studies—one randomized control trial, two prospective control trials, and a case–control surveillance on screening 401 articles. The three case–control studies were specifically on recurrence of clefts in high risk cases. The heterogeneity of the studies prevented conduction of a meta-analysis. But results of the studies demonstrate a strong association between high-dose folic acid and isolated nonsyndromic cleft lip with or without cleft palate (CL±CP). But such an effect is weak with regards to isolated cleft palate (CP). Conclusions With the limited evidence available, our conclusion is that high-dose folic acid probably has a role in prevention of recurrence of isolated CL±CP in high-risk individuals, but not CP.

scholarly journals Folic Acid Intake and Folate Status and Risk of Cervical Cancer: A Systematic Review and Meta-Analysis from 20 Independent Case-Control Studies and 4 RCTs

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 330-330
Author(s):  
Yuanxing Li ◽  
Aimin Yang ◽  
Wei Wang ◽  
Zhilian Wang ◽  
Zhe Wang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Folic Acid ◽  
Meta Analysis ◽  
Folate Deficiency ◽  
Folic Acid Supplementation ◽  
Case Control ◽  
Case Control Studies ◽  
Folic Acid Intake ◽  
Acid Supplementation ◽  
Acid Intake

Abstract Objectives Cervical cancer remains a common public health problem, despite its reduced morbidity and mortality. Exploring diverse prevention and treatment methods is essential. The aim of this meta-analysis was to evaluate the association between folic acid intake and status and the risk of cervical cancer, and discuss the feasibility of folic acid supplement. Methods We identified 369 articles via Ovid MEDLINE, Embase, PubMed, Springer, up to January 2019. Inclusion criteria were case-control study or RCT; folate intake or level was determined; outcomes included CIN and/or cervical cancer; correlations between folate and CIN/cervical cancer were studied; original data were obtained or calculated. We also performed these analyses within groups of studies defined by the following design characteristics: disease outcome (cervical intraepithelial neoplasia CIN, cervical cancer CC), samples resource (serum, plasma, red blood cell, diet record), location (European and American countries, Asian countries). All statistical calculations were performed using R Project software. Results Twenty-two case-control studies and four RCTs were included in the meta- analysis. From 22 case-control studies, there was a strong correlation between folate deficiency and risk of CIN or cancer (OR = 1.46, 95% CI [1.30, 1.63]). The overall analysis results were significantly heterogeneous (I2 = 49%, P < 0.01). The location is the main source of heterogeneity. For Asian regions, folate deficiency is a risk factor for CIN and CC (OR = 1.98, 95% CI [1.47, 2.66]; OR = 2.07, 95% CI [1.43, 3.76], respectively); however, for European and American regions, folate deficiency is only associated with CIN, OR = 1.16, 95% CI [1.01, 1.34]. From 4 RCT studies, the results showed that there was no significant correlation between folic acid supplementation and CIN outcome, RR = 1.17, 95% CI [0.90, 1.51]. Conclusions The overall study showed that folate deficiency significantly increased the risk of CIN and cervical cancer. However, the meta-analysis of 4 RCTs did not show the benefit of folic acid supplementation for CIN regression, probably due to the lack of RCTs, large time span, different folic acid supplementation doses, and different judging criteria of CIN. Further research is needed. Funding Sources N/A.

scholarly journals Maternal Periconceptional Folic Acid Supplementation and the Risk of Non-Syndromic Oral Clefts in Offspring: A Population-Based Case-Control Study in Chengdu, China

2021 ◽  
Author(s):  
Wenli Xu ◽  
Ling Yi ◽  
Changfei Deng ◽  
Ziling Zhao ◽  
Tianjin Zhou ◽  
...  
Keyword(s):  
Folic Acid ◽  
Cleft Palate ◽  
Statistical Power ◽  
Case Control Study ◽  
Population Based ◽  
Folic Acid Supplementation ◽  
Case Control ◽  
Oral Clefts ◽  
Acid Supplementation ◽  
Control Study

Abstract Maternal periconceptional folic acid supplementation (FAS) has been documented to be associated with decreased risk of nonsyndromic oral clefts (NsOC). However, the results remain inconclusive. In this population-based case-control study of 807 singletons affected by NsOC and 8070 healthy neonates who were born between October 2010 and September 2015 in Chengdu, China, we examined the association of maternal FAS with the risk of nonsyndromic cleft lip with or without cleft palate (NsCL/P), and cleft palate (NsCP). Unconditional logistic regression analysis was used to estimate the crude and adjusted odds ratios (ORs) and 95% confidential intervals (CI). Significant associations were found between maternal periconceptional FAS and decreased risk of NsCL/P (aOR = 0.41, 95% CI: 0.33–0.51). This protective effect was also detected for NsCL (aOR = 0.42, 95% CI: 0.30–0.58) and NsCLP (aOR = 0.41, 95% CI: 0.31–0.54). Both maternal FAS started before and after the last menstrual period (LMP) were negatively associated with NsCL/P (before LMP, aOR = 0.43, 95% CI: 0.33–0.56; after LMP, aOR = 0.41, 95% CI: 0.33–0.51). The association between NsCP and maternal FAS initiating before LMP was significant (aOR = 0.52, 95% CI: 0.30–0.90), but the statistical power seemed weak due to limited number of NsCP cases. The findings suggest that maternal periconceptional FAS can reduce the risk of each subtype of NsCL/P in offspring, while the potential effect on NsCP needs further investigations.

scholarly journals Relationship between caffeine intake and infertility: a systematic review of controlled clinical studies

2020 ◽  
Author(s):  
Bu Fanlong ◽  
Xue Feng ◽  
Xiao-Ying Yang ◽  
Jun Ren ◽  
Hui-juan Cao
Keyword(s):  
Systematic Review ◽  
Cohort Study ◽  
Clinical Studies ◽  
Meta Analysis ◽  
Case Control ◽  
Average Score ◽  
Caffeine Intake ◽  
High Dose ◽  
Case Control Studies ◽  
High Doses

Abstract Background: Previous studies showed that high dose of caffeine intake may induce some specific human reproductive system diseases, even lead to infertility. This review is aimed to systematically review the evidence from all controlled clinical studies of caffeine intake for infertility.Methods: Relevant randomized/quasi-randomized controlled trials, non-randomized clinical studies, cohort studies, and case-control studies were included. Participants were either those without a history of infertility who are willing to have a baby (for prospective studies) or infertile patients with confirmed diagnosis (for retrospective studies). Caffeine or caffeine-containing beverage was observed as the exposure factor. The key outcome was the diagnosis of infertility.Results: Four studies (one cohort study and three case-control studies) involving 12912 participants were included. According Newcastle - Ottawa Scale (NOS), the average score of case-control studies was 6, and the cohort study achieved 9. Meta-analysis and subgroup analysis were conducted. The results showed that low (OR 0.95, 95%CI 0.78-1.16), medium (OR 1.14, 95%CI 0.69-1.86) and high doses (OR 1.86, 95%CI 0.28-12.22) of caffeine intake may not increase the risk of infertility. The GRADE method was used to assess the certainty of the evidence and the results showed that the quality of the three evidence bodies were all low.Conclusion: Our study provides low quality evidence that regardless of low, medium and high doses of caffeine intake do not appear increase the risk of infertility. But the conclusion should be treated with caution. Systematic review registration: PROSPERO CRD42015015714

Maternal Common Cold or Fever During Pregnancy and the Risk of Orofacial Clefts in the Offspring: A Systematic Review and Meta-analysis

2021 ◽  
pp. 105566562110676
Author(s):  
Fang-ping Shi ◽  
Ying-ying Huang ◽  
Qiao-qun Dai ◽  
Yu-lu Chen ◽  
Hai-yin Jiang ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Common Cold ◽  
Cleft Lip ◽  
Meta Analysis ◽  
Case Control Studies ◽  
Orofacial Clefts ◽  
Random Effects Models ◽  
Relative Risks ◽  
Increased Risk ◽  
The Common

The common cold and/or an associated fever during pregnancy have/has been suspected to harm the developing fetus. We sought possible correlations between a maternal common cold or fever during pregnancy and the risk of orofacial clefts in the offspring. We systematically searched PubMed and Embase using appropriate keywords, and we checked the reference lists of retrieved articles. We used random-effects models to estimate overall relative risks. Incidence of orofacial clefts. We included 13 case-control studies. Modest but statistically significant associations were found between a maternal common cold and cleft lip with or without a cleft palate (CL/CP) (odds ratio [OR] 2.17; 95% confidence interval [CI] 1.66–2.83) and a cleft palate only (CPO) (OR 3.08; 95% CI 1.5–6.34). Furthermore, maternal fever was also associated with an increased risk of CL/CP (OR 1.91, 95% CI 1.3–2.8) and CPO (OR 1.48, 95% CI 0.83–2.63) in the offspring. Further analyses of maternal influenza (alone) yielded similar results. Although evidence of heterogeneity should be carefully evaluated, our findings suggest that maternal common cold or fever during pregnancy may be associated with a greater risk of CL/CP or CPO in the offspring. Future cohort studies using valid assessments of maternal common cold exposure during pregnancy that consider the severity of fever are needed to clarify the contribution of maternal common cold or fever status to the risk of orofacial clefts in children.

Stability of Orofacial Clefting Rate in Alberta, 1980–2011

2014 ◽  
Vol 51 (6) ◽  
pp. 113-121 ◽  
Author(s):  
R. Brian Lowry ◽  
Barbara Sibbald ◽  
Tanya Bedard
Keyword(s):  
Folic Acid ◽  
Cleft Palate ◽  
Congenital Anomalies ◽  
Cleft Lip ◽  
Folic Acid Supplementation ◽  
Multiple Sources ◽  
Orofacial Clefts ◽  
Folic Acid Fortification ◽  
Orofacial Clefting ◽  
The Impact

Objective To determine the prevalence and trends of orofacial clefts in Alberta (Canada) over a 33-year period (1980 through 2011) and to determine whether the trends differ for subcategories of orofacial clefts for the period from 1997 through 2011. Design A prevalence study based on the Alberta Congenital Anomalies Surveillance System, which has multiple sources of ascertainment, capability of verification, and an upper age limit of 1 year. Inclusion All live born and stillborn babies and fetal deaths less than 20 weeks' gestation (including terminations of pregnancy) born in Alberta of mothers who reside in Alberta. Results and Conclusions Rates for cleft lip with or without cleft palate and cleft palate only have been very stable over the 33-year period (1980 through 2011). These rates include all clefts (isolated, syndromes, recognizable conditions, chromosomal and multiple congenital anomalies). Ascertainment of fetal deaths less than 20 weeks' gestation began in 1997. There are trends for the 1997 through 2011 cohort with a marginally significant increase for cleft lip with or without cleft palate in the isolated category and a significant decrease for cleft palate, mainly in the associated groups. The impact of folic acid fortification and/or multivitamins/folic acid supplementation reports in the literature have shown no consensus with respect to a change in the prevalence of orofacial clefts. It is unclear whether folic acid fortification has had any impact in Alberta.

scholarly journals Homocysteine and Folic Acid: Risk Factors for Alzheimer's Disease—An Updated Meta-Analysis

2021 ◽  
Vol 13 ◽  
Author(s):  
Qianwen Wang ◽  
Jingjing Zhao ◽  
Hongtao Chang ◽  
Xu Liu ◽  
Ruixia Zhu
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Folic Acid ◽  
Cohort Studies ◽  
Prospective Cohort ◽  
Meta Analysis ◽  
Case Control ◽  
Case Control Studies ◽  
Prospective Cohort Studies ◽  
Increased Risk

Background: Recent studies have reported that homocysteine (Hcy) may play a vital role in the pathogenesis of vascular dementia (VaD) and Alzheimer's disease (AD). Our study explored the relationship between the plasma Hcy and folate levels and the risk of dementia.Methods: We searched Embase, PubMed, and Web of Science for published literature, including case-control studies and prospective cohort studies, and performed a systematic analysis.Results: The results of our meta-analysis, consisting of case-control studies, showed higher levels of Hcy and lower levels of folate in dementia, AD, and VaD patients than those in non-demented controls (for dementia: SMD = 0.812, 95% CI [0.689, 0.936], p = 0.000 for Hcy; SMD = −0.677, 95% CI [−0.828, −0.525], p = 0.000 for folate). AD patients showed significantly lower plasma Hcy levels compared to VaD patients (SMD = −0.278, 95% CI [−0.466, −0.09], p = 0.000). Subgroup analysis revealed that ethnicity, average age, and dementia type had no significant effect on this association. Furthermore, from the analysis of prospective cohort studies, we identified that elevated plasma Hcy levels were associated with an increased risk of dementia, AD, and VaD (RRdementia = 1.22, 95% CI [1.08, 1.36]; RRAD = 1.07, 95% CI [1.04, 1.11]; RRVaD = 1.13, 95% CI [1.04, 1.23]). In addition, every 5 μmol/L increase in the plasma Hcy level was associated with a 9% increased risk of dementia and a 12% increased risk of AD.Conclusion: Hcy and folic acid are potential predictors of the occurrence and development of AD. A better understanding of their function in dementia could provide evidence for clinicians to rationalize clinical intervention strategies.

scholarly journals Effects of folic acid fortification on orofacial clefts prevalence: a meta-analysis

2017 ◽  
Vol 20 (12) ◽  
pp. 2260-2268 ◽  
Author(s):  
Natalia Millacura ◽  
Rosa Pardo ◽  
Lucia Cifuentes ◽  
José Suazo
Keyword(s):  
Folic Acid ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Meta Analysis ◽  
Orofacial Clefts ◽  
Folic Acid Fortification ◽  
Scientific Databases ◽  
Beneficial Effects ◽  
Study Heterogeneity ◽  
Mandatory Policy

AbstractObjectiveOrofacial clefts (OFC) are the most prevalent craniofacial birth defect. Folic acid (FA) supplementation has been demonstrated as an effective intervention to reduce risk of OFC occurrence. However, the effect of mandatory FA fortification of wheat and/or maize flour on OFC prevalence has shown controversial results among countries adopting this policy. Thus, we performed a meta-analysis to synthesize the available evidence evaluating the global impact of this mandatory policy on OFC occurrence.DesignLiterature search in conventional and grey medical/scientific databases showed fifteen studies considering OFC prevalence in pre- and post-fortification periods with FA. The effect of this policy was evaluated by computing relative risk (RR) and separating samples into total OFC, non-syndromic forms, cleft lip with or without cleft palate (CL/P) and cleft palate only (CPO).ResultsWe found a significant effect of FA fortification only on non-syndromic CL/P (RR=0·88; 95 % CI 0·81, 0·96), whereas neutral effects were detected for total OFC (syndromic plus non-syndromic) and CPO.ConclusionsOur results may reflect the different aetiology of syndromic OFC with respect to non-syndromic forms and the CL/P related to CPO. Although the number of non-syndromic CL/P samples was lower than that for total OFC, the absence of both between-study heterogeneity and publication bias leads us to conclude that FA fortification may have beneficial effects on non-syndromic CL/P.

Maternal Cigarette Smoking and Oral Clefts: A Meta-analysis

1997 ◽  
Vol 34 (3) ◽  
pp. 206-210 ◽  
Author(s):  
Diego F. Wyszynski ◽  
David L. Duffy ◽  
Terri H. Beaty
Keyword(s):  
Cigarette Smoking ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Meta Analysis ◽  
First Trimester ◽  
Case Control Studies ◽  
Oral Clefts ◽  
Oral Cleft ◽  
Maternal Cigarette Smoking ◽  
Increased Risk

Objective A meta-analysis was performed to estimate the association between maternal cigarette smoking and the risk of having a child with a nonsyndromic oral cleft (NSOC). Design Studies published from 1966 through 1996 were retrieved using MEDLINE, Current Contents, bibliographies, and other sources. MEDLINE and Current Contents search terms included “oral clefts,” “cigarette smoking,” “birth defects,” and “congenital malformations.” Cohort and case-control studies that enrolled oral cleft patients [cleft lip with or without cleft palate (CL/P), cleft palate (CP), or both] and controls, and presented information on maternal cigarette exposure during pregnancy were included in the analysis. Descriptive and outcome data from each study were independently abstracted by two authors. Results The overall odds ratio of the 11 studies satisfying criteria was 1.29 [95% confidence interval (CI), 1.18 to 1.42] for CL/P and 1.32 (95% CI: 1.10 to 1.62) for CP, Indicating a small increased risk of having a child with either a CL/P or a CP for mothers who smoke during the first trimester of the pregnancy. Conclusions These analyses suggest a small but statistically significant association between maternal cigarette smoking during the first trimester of gestation and increased risk of having a child with a CL/P or CP.

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