ABSTRACT
Background: Congenital heart defects [CHDs] are significant drivers of mortality and morbidity in children, folic acid supplementation for the pregnant month during or before delivery is said to influence risk reduction of congenital heart defects [CHDs]. However, there are controversial claims and the hypothesis is concluded from limited epidemiologic studies
Aim of the Study: Conduct a systematic review and meta-analysis of published studies to reliably evaluate the correlation between Folic acid or multivitamins containing FA supplementation taken during pregnancy and the risk of CHDs
Methods: A systematic review and meta-analysis was conducted. PUBMED and EMBASE were searched to identify prospective cohort and case-control studies that had reported on the association between 1960 and 2017. Studies conducted in primarily high-risk populations [Case control and cohort studies] while participants in randomized controlled trials were excluded
Results: The search yielded 10 studies published between 2000 and 2013 enrolling 13126 female participants. These studies included only one cohort study, and nine case-control studies. The overall results of this meta-analysis provide evidence that maternal folate supplementation is associated with a significantly decreased risk of CHDs [RR = 0.69, 95% CI: 0.54-0.84]. Statistically significant heterogeneity was detected [Q = 79.43, P < 0.001, I2 = 70.2%]
Conclusion: FA supplementation during pregnancy significantly decreases the risk of CHDs in newborns
ABSTRACT
Purpose: to review the incidence and risk factors for retinopathy of prematurity [ROP] King Faisal Specialist Hospital and King Abdulaziz University Hospital in Jeddah, Saudi Arabia
Material and methods: In this prospective cohort study, preterm infants who were admitted to a neonatal intensive care unit from 2012 to 2013 were evaluated for ROP. Inclusion criteria were, preterm infants with gestational age <32 weeks and/or birth weight <1500 g. The risk factors that were assessed were intraventricular hemorrhage, patent ductus arteriosus [PDA], sepsis and hydrocephalus. The relative risk was used to measure the risk and logistic regression was used to adjust for confounding factors. Statistical significance was indicated by p < 0.05
Results: thirty-one of 92 [33.7%] preterm infants had unilateral or bilateral ROP. The mean gestational age was 26.7 weeks [range, 24-29 weeks] and mean birth weight was 0.843 kg [range, 0.606-1.450 kg]. There were 7 infants with stage 1 ROP, 10 infants with stage 2, 14 infants with stage 3 and no cases of stage 4 or 5. Twelve [13%] infants had plus disease and received laser therapy within 72 h of diagnosis. Statistically significant risk factors for ROP were PDA [p = 0.0005] and intraventricular hemorrhage [p = 0.0005]
Conclusion: the incidence of ROP was 33.7% and risk factors were PDA and intraventricular hemorrhage. Laser therapy was very effective for the treatment of plus disease and preventing progression of ROP. Clinicians should assess for potential risk factors when monitoring premature infants