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Effects and safety of periconceptional folate supplementation for preventing birth defects

  1. Luz Maria De-Regil1,*,
  2. Ana C Fernández-Gaxiola2,
  3. Therese Dowswell3,
  4. Juan Pablo Peña-Rosas1

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 6 OCT 2010

Assessed as up-to-date: 10 AUG 2010

DOI: 10.1002/14651858.CD007950.pub2


How to Cite

De-Regil LM, Fernández-Gaxiola AC, Dowswell T, Peña-Rosas JP. Effects and safety of periconceptional folate supplementation for preventing birth defects. Cochrane Database of Systematic Reviews 2010, Issue 10. Art. No.: CD007950. DOI: 10.1002/14651858.CD007950.pub2.

Author Information

  1. 1

    World Health Organization, Micronutrients Unit, Department of Nutrition for Health and Development, Geneva, Geneva, Switzerland

  2. 2

    Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico

  3. 3

    The University of Liverpool, Cochrane Pregnancy and Childbirth Group, School of Reproductive and Developmental Medicine, Division of Perinatal and Reproductive Medicine, Liverpool, UK

*Luz Maria De-Regil, Micronutrients Unit, Department of Nutrition for Health and Development, World Health Organization, 20 Avenue Appia, Geneva, Geneva, 1211, Switzerland. deregillu@who.int.

Publication History

  1. Publication Status: New
  2. Published Online: 6 OCT 2010

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This is not the most recent version of the article. View current version (14 DEC 2015)

[Figure 1]
Figure 1. Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
[Figure 2]
Figure 2. Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
[Analysis 1.1]
Analysis 1.1. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 1 Neural tube defects (ALL).
[Analysis 1.2]
Analysis 1.2. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 2 Neural tube defects (by subgroups).
[Analysis 1.3]
Analysis 1.3. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 3 Cleft palate (ALL).
[Analysis 1.4]
Analysis 1.4. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 4 Cleft palate (by subgroups).
[Analysis 1.5]
Analysis 1.5. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 5 Cleft lip (ALL).
[Analysis 1.6]
Analysis 1.6. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 6 Cleft lip (by subgroups).
[Analysis 1.7]
Analysis 1.7. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 7 Congenital cardiovascular defects (ALL).
[Analysis 1.8]
Analysis 1.8. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 8 Congenital cardiovascular defects (by subgroups).
[Analysis 1.9]
Analysis 1.9. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 9 Other birth defects (any) (ALL).
[Analysis 1.10]
Analysis 1.10. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 10 Other birth defects (by subgroups).
[Analysis 1.11]
Analysis 1.11. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 11 Miscarriage (ALL).
[Analysis 1.12]
Analysis 1.12. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 12 Miscarriage (by subgroups).
[Analysis 1.13]
Analysis 1.13. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 13 Stillbirth (ALL).
[Analysis 1.14]
Analysis 1.14. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 14 Stillbirth (by subgroups).
[Analysis 1.15]
Analysis 1.15. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 15 Multiple pregnancy (ALL).
[Analysis 1.16]
Analysis 1.16. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 16 Multiple pregnancy (by subgroups).
[Analysis 1.17]
Analysis 1.17. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 17 Pregnancy termination for fetal abnormality (ALL).
[Analysis 1.18]
Analysis 1.18. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 18 Pregnancy termination for fetal abnormality (by subgroups).
[Analysis 1.19]
Analysis 1.19. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 19 Low birthweight (ALL).
[Analysis 1.20]
Analysis 1.20. Comparison 1 Supplementation with folic acid versus no treatment/other micronutrients/placebo, Outcome 20 Low birthweight (by subgroups).
[Analysis 2.1]
Analysis 2.1. Comparison 2 Supplementation with folic acid alone versus no treatment/placebo, Outcome 1 Neural tube defects (ALL).
[Analysis 2.2]
Analysis 2.2. Comparison 2 Supplementation with folic acid alone versus no treatment/placebo, Outcome 2 Neural tube defects (by subgroups).
[Analysis 2.3]
Analysis 2.3. Comparison 2 Supplementation with folic acid alone versus no treatment/placebo, Outcome 3 Cleft palate (ALL).
[Analysis 2.4]
Analysis 2.4. Comparison 2 Supplementation with folic acid alone versus no treatment/placebo, Outcome 4 Cleft palate (by subgroups).
[Analysis 2.5]
Analysis 2.5. Comparison 2 Supplementation with folic acid alone versus no treatment/placebo, Outcome 5 Cleft lip (ALL).
[Analysis 2.6]
Analysis 2.6. Comparison 2 Supplementation with folic acid alone versus no treatment/placebo, Outcome 6 Cleft lip (by subgroups).
[Analysis 2.7]
Analysis 2.7. Comparison 2 Supplementation with folic acid alone versus no treatment/placebo, Outcome 7 Congenital cardiovascular defects (ALL).
[Analysis 2.8]
Analysis 2.8. Comparison 2 Supplementation with folic acid alone versus no treatment/placebo, Outcome 8 Congenital cardiovascular defects (by subgroups).
[Analysis 2.9]
Analysis 2.9. Comparison 2 Supplementation with folic acid alone versus no treatment/placebo, Outcome 9 Other birth defects (any) (ALL).
[Analysis 2.10]
Analysis 2.10. Comparison 2 Supplementation with folic acid alone versus no treatment/placebo, Outcome 10 Other birth defects (by subgroups).
[Analysis 2.11]
Analysis 2.11. Comparison 2 Supplementation with folic acid alone versus no treatment/placebo, Outcome 11 Miscarriage (ALL).
[Analysis 2.12]
Analysis 2.12. Comparison 2 Supplementation with folic acid alone versus no treatment/placebo, Outcome 12 Miscarriage (by subgroups).
[Analysis 2.13]
Analysis 2.13. Comparison 2 Supplementation with folic acid alone versus no treatment/placebo, Outcome 13 Stillbirth (ALL).
[Analysis 2.14]
Analysis 2.14. Comparison 2 Supplementation with folic acid alone versus no treatment/placebo, Outcome 14 Stillbirth (by subgroups).
[Analysis 2.17]
Analysis 2.17. Comparison 2 Supplementation with folic acid alone versus no treatment/placebo, Outcome 17 Pregnancy termination for fetal abnormality (ALL).
[Analysis 2.18]
Analysis 2.18. Comparison 2 Supplementation with folic acid alone versus no treatment/placebo, Outcome 18 Pregnancy termination for fetal abnormality (by subgroups).
[Analysis 3.1]
Analysis 3.1. Comparison 3 Supplementation with folic acid + other micronutrients versus no treatment/placebo, Outcome 1 Neural tube defects (ALL).
[Analysis 3.2]
Analysis 3.2. Comparison 3 Supplementation with folic acid + other micronutrients versus no treatment/placebo, Outcome 2 Neural tube defects (by subgroups).
[Analysis 3.3]
Analysis 3.3. Comparison 3 Supplementation with folic acid + other micronutrients versus no treatment/placebo, Outcome 3 Cleft palate (ALL).
[Analysis 3.4]
Analysis 3.4. Comparison 3 Supplementation with folic acid + other micronutrients versus no treatment/placebo, Outcome 4 Cleft palate (by subgroups).
[Analysis 3.5]
Analysis 3.5. Comparison 3 Supplementation with folic acid + other micronutrients versus no treatment/placebo, Outcome 5 Cleft lip (ALL).
[Analysis 3.6]
Analysis 3.6. Comparison 3 Supplementation with folic acid + other micronutrients versus no treatment/placebo, Outcome 6 Cleft lip (by subgroups).
[Analysis 3.7]
Analysis 3.7. Comparison 3 Supplementation with folic acid + other micronutrients versus no treatment/placebo, Outcome 7 Congenital cardiovascular defects (ALL).
[Analysis 3.8]
Analysis 3.8. Comparison 3 Supplementation with folic acid + other micronutrients versus no treatment/placebo, Outcome 8 Congenital cardiovascular defects (by subgroups).
[Analysis 3.9]
Analysis 3.9. Comparison 3 Supplementation with folic acid + other micronutrients versus no treatment/placebo, Outcome 9 Other birth defects (any) (ALL).
[Analysis 3.10]
Analysis 3.10. Comparison 3 Supplementation with folic acid + other micronutrients versus no treatment/placebo, Outcome 10 Other birth defects (by subgroups).
[Analysis 3.11]
Analysis 3.11. Comparison 3 Supplementation with folic acid + other micronutrients versus no treatment/placebo, Outcome 11 Miscarriage (ALL).
[Analysis 3.12]
Analysis 3.12. Comparison 3 Supplementation with folic acid + other micronutrients versus no treatment/placebo, Outcome 12 Miscarriage (by subgroups).
[Analysis 3.13]
Analysis 3.13. Comparison 3 Supplementation with folic acid + other micronutrients versus no treatment/placebo, Outcome 13 Stillbirth (ALL).
[Analysis 3.14]
Analysis 3.14. Comparison 3 Supplementation with folic acid + other micronutrients versus no treatment/placebo, Outcome 14 Stillbirth (by subgroups).
[Analysis 4.1]
Analysis 4.1. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 1 Neural tube defects (ALL).
[Analysis 4.2]
Analysis 4.2. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 2 Neural tube defects (by subgroups).
[Analysis 4.3]
Analysis 4.3. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 3 Cleft palate (ALL).
[Analysis 4.4]
Analysis 4.4. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 4 Cleft palate (by subgroups).
[Analysis 4.5]
Analysis 4.5. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 5 Cleft lip (ALL).
[Analysis 4.6]
Analysis 4.6. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 6 Cleft lip (by subgroups).
[Analysis 4.7]
Analysis 4.7. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 7 Congenital cardiovascular defects (ALL).
[Analysis 4.8]
Analysis 4.8. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 8 Congenital cardiovascular defects (by subgroups).
[Analysis 4.9]
Analysis 4.9. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 9 Other birth defects (any) (ALL).
[Analysis 4.10]
Analysis 4.10. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 10 Other birth defects (by subgroups).
[Analysis 4.11]
Analysis 4.11. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 11 Miscarriage (ALL).
[Analysis 4.12]
Analysis 4.12. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 12 Miscarriage (by subgroups).
[Analysis 4.13]
Analysis 4.13. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 13 Stillbirth (ALL).
[Analysis 4.14]
Analysis 4.14. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 14 Stillbirth (by subgroups).
[Analysis 4.15]
Analysis 4.15. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 15 Multiple pregnancy (ALL).
[Analysis 4.16]
Analysis 4.16. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 16 Multiple pregnancy (by subgroups).
[Analysis 4.17]
Analysis 4.17. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 17 Pregnancy termination for fetal abnormality (ALL).
[Analysis 4.18]
Analysis 4.18. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 18 Pregnancy termination for fetal abnormality (by subgroups).
[Analysis 4.19]
Analysis 4.19. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 19 Low birthweight (ALL).
[Analysis 4.20]
Analysis 4.20. Comparison 4 Supplementation with folic acid + other micronutrients versus other micronutrients (without folic acid), Outcome 20 Low birthweight (by subgroups).