Hostname: page-component-76fb5796d-r6qrq Total loading time: 0 Render date: 2024-04-28T07:13:46.283Z Has data issue: false hasContentIssue false
  • English
  • Français

The Higher Rate of Multiple Births After Periconceptional Multivitamin Supplementation: An Analysis of Causes

Published online by Cambridge University Press:  01 August 2014

A.E. Czeizel ,
J. Métneki  and
I. Dudás
A.E. Czeizel*
Affiliation:
Department of Human Genetics and Teratology, National Institute of Hygiene- WHO Collaborating Centre for the Community Control of Hereditary Diseases, Budapest, Hungary
J. Métneki
Affiliation:
Department of Human Genetics and Teratology, National Institute of Hygiene- WHO Collaborating Centre for the Community Control of Hereditary Diseases, Budapest, Hungary
I. Dudás
Affiliation:
Department of Human Genetics and Teratology, National Institute of Hygiene- WHO Collaborating Centre for the Community Control of Hereditary Diseases, Budapest, Hungary
*
H-1966 Budapest, OKI, Gyáli út 2-6, Hungary

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

A randomized controlled trial of periconceptional multivitamin supplementation (including 0.8 mg folic acid – see the Materials and Methods section for the precise composition of the multivitamin and trace-element supplementation) was carried out for at least 28 days before conception. The trial was continued until at least until the second missed menstrual period to test the effectiveness of this new primary preventive method in the reduction of neural tube defects. However, other pregnancy outcomes were also evaluated. Of a total of 5,502 pregnant women, 4,846 births were analysed in the final data base. The rate of multiple births was significantly higher in the multivitamin group (3.8%) than in the placebo-like trace-element control group (2.7%), and in both groups exceeded the multiple birth rate of 2.2% in the Hungarian population at large. 7.3% of women in the multivitamin and 7.9% of women in the trace-element groups had received ovarian stimulation treatment (mainly clomiphene) for hormonal dysfunctions, eg. anovulation. Nonetheless, our study showed that periconceptional multivitamin supplementation, with or without ovarian stimulation, increases the rate of multiple births.

Keywords

Multiple birthsPericonceptional multivitamin supplementationOvarian stimulation
Type
Research Article
Information
Acta geneticae medicae et gemellologiae: twin research , Volume 43 , Issue 3-4 , October 1994 , pp. 175 - 184
Copyright
Copyright © The International Society for Twin Studies 1994

References

REFERENCES

1. Bower, C, Stanley, FJ (1989): Dietary folate as a risk factor for neural-tube defects: evidence from a case-control study in Western Australia. Med J Aust 150: 613–619.Google Scholar
2. Centers for Disease Control and Prevention (1992, 1993): Recommendations for use of folic acid to reduce the number of spina bifida cases and other neural-tube defects. Morbidity and Mortality Weekly Report (MMWR) 41:RR 14 and JAMA 269:1233–1238.Google Scholar
3. Czeizel, AE (1988): Medical genetics in Hungary. J Med Genet 25: 2–8.Google Scholar
4. Czeizel, AE (1989): Ovulation induction and neural tube defects. Lancet 2:167.Google Scholar
5. Czeizel, AE, Dudás, I (1992): Prevention of the first occurrence of neural-tube defects by periconceptional multivitamin supplementation. N Engl J Med 327: 1832–1835.Google Scholar
6. Czeizel, AE, Dudás, I, Fritz, G (1992): The check-up of reproductive health and genetic counseling. Genet Counseling 3: 61–66.Google Scholar
7. Czeizel, AE, Métneki, J, Dudás, I (1994): Higher rate of multiple births after periconceptional multivitamin supplementation. N Engl J Med 23: 1687–1688.Google Scholar
8. Dziadek, M (1993): Preovulatory administration of chlomiphene citrate to mice causes fetal growth retardation and neural tube defects (exencephaly) by an indirect maternal effect. Teratology 47: 263–273.Google Scholar
9. Elwood, JM, Little, J, Elwood, JH (1992): Epidemiology and Control of Neural Tube Defects. Oxford: Oxford Univ. Press.Google Scholar
10. Hartikainen-Sorvi, A-L, Kaupilla, A, Tuyimala, R, Koivisto, M (1983): Factors related to an improved outcome for twins. Acta Obstet Gynecol Scand 63: 23–25.Google Scholar
11. Laurence, KM, James, N, Miller, HM, Tennant, GB, Campbell, H (1981): Double-blind randomised controlled trial of folate treatment before conception to prevent recurrence of neural-tube defects. Br Med J 282: 1509–1511.Google Scholar
12. Lindemann, MD, Kornegay, ET (1989): Folic acid supplementation to diets of gestating-lactating swine over multiple parities. J Anim Sci 67: 459–464.Google Scholar
13. Matte, JJ, Girard, GL, Brisson, GJ (1981): Serum levels during the reproductive cycle of sows. J Anim Sci 55 (Suppl. 1): 284.Google Scholar
14. Matte, JJ, Girard, GL, Brisson, GJ (1984): Serum folates during the reproductive cycle of sows. J Amin Sci 59:158.Google Scholar
15. Matte, JJ, Girard, GL, Brisson, GJ (1984): Folic acid and reproductive performance of sows. J Anim Sci 59: 1020–1025.Google Scholar
16. Mills, JL, Simpson, JL, Rhoads, GG et al (1990): Risk of neural-tube defects in relation to maternal fertility drug use. Lancet 336: 103–104.Google Scholar
17. Milunsky, A, Jick, H, Jick, SS, Bruell, CL, MacLaughlin, DS, Rothman, KJ, Willett, W (1989): Multivitamin/folic acid supplementation in early pregnancy reduces the prevalence of neural tube defects. JAMA 262: 2847–2852.Google Scholar
18. MRC Vitamin Study Research Group. Prevention of neural-tube defects (1991): results of the Medical Research Council Vitamin Study. Lancet 338: 131–137.Google Scholar
19. Mulinare, J, Cordero, JF, Erickson, JD, Berry, RJ (1988): Periconceptional use of multivitamins and the occurrence of neural tube defects. JAMA 260: 3141–3145.Google Scholar
20. O'Connor, MC, Arias, E, Royston, JP, Dalrymple, IJ (1981): The merits of special antenatal care for twin pregnancies. Br J Obstet Gynaecol 88: 222–230.Google Scholar
21. Smithells, RW, Sheppoard, S, Wild, J, Schorah, CJ (1989): Prevention of neural-tube defect recurrences in Yorkshire: Final report. Lancet 2: 498–499.Google Scholar
22. Smithells, RW, Sheppard, S, Schorah, CJ, Seller, MJ, Nevin, NC, Harris, R, Read, AP, Fielding, DW (1980): Possible prevention of neural-tube defects by periconceptional vitamin supplementation Lancet 1:339–340.Google Scholar
23. Tremblay, GF, Matte, JJ, Dufour, JJ, Brisson, GJ (1989): Survival rate and development of fetuses during the first 30 days of gestation after folic acid addition to a swine diet. J Anim Sci 67: 724–732.Google Scholar
24. Werler, MM, Shapiro, S, Mitshell, AA (1993): Periconceptional folic acid exposure and risk of occurrent neural-tube defects. JAMA 269: 1257–1261.Google Scholar
25. Willemsen, W, Kruitwagen, R, Bastiaans, B, Hanselaar, T, Rolland, R (1993): Ovarian stimulation and granulosa-cell tumour. Lancet 341: 986–988.Google Scholar