1. Dietary folate intake and fecundability in two preconception cohorts
- Author
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Heidi T Cueto, Bjarke H Jacobsen, Anne Sofie Dam Laursen, Anders H Riis, Elizabeth E Hatch, Lauren A Wise, Ellen Trolle, Henrik Toft Sørensen, Kenneth J Rothman, Amelia K Wesselink, Sydney Willis, Benjamin R Johannesen, and Ellen M Mikkelsen
- Subjects
fecundability ,preconception ,Rehabilitation ,Obstetrics and Gynecology ,General Medicine ,Original Articles ,dietary folate ,Eating ,Fertility ,Folic Acid ,pregnancy planners ,Reproductive Medicine ,Pregnancy ,Fertilization ,cohort study ,Humans ,Female ,Prospective Studies ,Child ,folic acid supplementation - Abstract
STUDY QUESTION To what extent is dietary folate intake and total folate intake (dietary and supplemental intakes) associated with fecundability, the per cycle probability of conception? SUMMARY ANSWER Preconception dietary folate intake was positively associated with fecundability in a monotonic pattern. WHAT IS KNOWN ALREADY Supplemental folic acid has been associated with improved fertility, but little is known about the relation between dietary folate and fecundability. STUDY DESIGN, SIZE, DURATION A prospective cohort study including 9559 women trying to conceive without fertility treatment and enrolled in the period 2013-2020. PARTICIPANTS/MATERIALS, SETTING, METHODS We used data from two internet-based prospective cohort studies of pregnancy planners from Denmark, where folic acid fortification is not performed (SnartForældre.dk (SF); n = 3755) and North America, where the food supply is fortified with folic acid (Pregnancy Study Online (PRESTO); n = 5804). Women contributed menstrual cycles at risk until they reported conception or experienced a censoring event. We used proportional probabilities regression models to compute fecundability ratios (FRs) and 95% CI, adjusting for potential confounders. MAIN RESULTS AND THE ROLE OF CHANCE Compared with a dietary folate intake ≥400 µg/day, the adjusted FRs for women in SF were 0.92 (95% CI: 0.85–0.99) for intake 250–399 µg/day, and 0.80 (95% CI: 0.68–0.94) for intake of LIMITATIONS, REASONS FOR CAUTION It is unknown whether dietary folate and folic acid intake affect fecundability on its own or if there is an interaction with other micronutrients provided in healthy diet. Thus, the observed associations may not reflect dietary folate intake alone, but overall healthy diet. WIDER IMPLICATIONS OF THE FINDINGS Recommendations for preconception dietary folate intake and folic acid supplementation are of importance not only to prevent neural tube defects but also to enhance fecundability. STUDY FUNDING/COMPETING INTEREST(S) The study was supported by the National Institute of Child Health and Human Development (R01-HD086742). The authors report no competing interests. TRIAL REGISTRATION NUMBER N/A.
- Published
- 2022