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New Neural Tube Defects Study Findings Reported from Hvidovre University Hospital (Multivitamin use and adverse birth outcomes in high-income...

Clinical Trials Week

10-13-17

New Neural Tube Defects Study Findings Reported from Hvidovre University Hospital (Multivitamin use and adverse birth outcomes in high-income countries: a systematic review and meta-analysis)

By a News Reporter-Staff News Editor at Clinical Trials Week -- Investigators publish new report on Birth Defects - Neural Tube Defects. According to news reporting originating in Hvidovre, Denmark, by NewsRx journalists, research stated, "In high-income countries, a healthy diet is widely accessible. However, a change toward a poor-quality diet with a low nutritional value in high-income countries has led to an inadequate vitamin intake during pregnancy."

The news reporters obtained a quote from the research from Hvidovre University Hospital, "We conducted a systematic review and meta-analysis to evaluate the association between multivitamin use among women in high-income countries and the risk of adverse birth outcomes (preterm birth [primary outcome], low birthweight, small for gestational age, stillbirth, neonatal death, perinatal mortality, and congenital anomalies without further specification). We searched electronic databases (MEDLINE, Embase, Cochrane, Scopus, and CINAHL) from inception to June 17, 2016, using synonyms of pregnancy, study/trial type, and multivitamins. Eligible studies were all studies in high-income countries investigating the association between multivitamin use (3 or more vitamins or minerals in tablets or capsules) and adverse birth outcomes. We evaluated randomized, controlled trials using the Cochrane Collaboration tool. Observational studies were evaluated using the Newcastle-Ottawa Scale. Meta-analyses were applied on raw data for outcomes with data for at least 2 studies and were conducted using RevMan (version 5.3). Outcomes were pooled using the random-effect model. The quality of evidence was assessed using the Grades of Research, Assessment, Development and Evaluation approach. We identified 35 eligible studies including 98,926 women. None of the studies compared the use of folic acid and iron vs the use of multivitamins. The use of multivitamin did not change the risk of the primary outcome, preterm birth (relative risk, 0.84 [95% confidence interval, 0.69-1.03]). However, the risk of small for gestational age (relative risk, 0.77 [95% confidence interval, 0.63-0.93]), neural tube defects (relative risk, 0.67 [95% confidence interval, 0.52-0.87]), cardiovascular defects (relative risk, 0.83 [95% confidence interval, 0.70-0.98]), urine tract defects (relative risk, 0.60 [95% confidence interval, 0.46-0.78]), and limb deficiencies (relative risk, 0.68 [95% confidence interval, 0.52-0.89]) was decreased. Of the 35 identified studies, only 4 were randomized, controlled trials. The degree of clinical evidence according to the Grades of Research, Assessment, Development, and Evaluation system was low or very low for all outcomes except for recurrence of neural tube defects in which a moderate degree of clinical evidence was found. Routine multivitamin use in high-income countries can be recommended but with caution because of the low quality of evidence."

According to the news reporters, the research concluded: "Randomized, controlled trials or well-performed, large prospective cohort studies are needed."

For more information on this research see: Multivitamin use and adverse birth outcomes in high-income countries: a systematic review and meta-analysis. American Journal of Obstetrics and Gynecology, 2017;217(4):404-412,83-103. American Journal of Obstetrics and Gynecology can be contacted at: Mosby-Elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA. (Elsevier - www.elsevier.com; American Journal of Obstetrics and Gynecology - www.journals.elsevier.com/american-journal-of-obstetrics-and-gynecology/)

Our news correspondents report that additional information may be obtained by contacting H.T. Wolf, Hvidovre Univ Hosp, Copenhagen Univ Hosp, Dept. of Obstet & Gynaecol, Hvidovre, Denmark. Additional authors for this research include H.K. Hegaard, L.D. Huusom and A.B. Pinborg (see also Birth Defects - Neural Tube Defects).

Keywords for this news article include: Hvidovre, Denmark, Europe, Clinical Research, Article Review, Risk and Prevention, Nervous System Diseases and Conditions, Nervous System Malformations, Clinical Trials and Studies, Neural Tube Defects, Birth Defects, Genetics, Hvidovre University Hospital.

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