British Journal of Nutrition

Dietary Surveys and Nutritional Epidemiology

Periconceptional folic acid supplementation and anthropometric measures at birth in a cohort of pregnant women in Valencia, Spain

Maria Pastor-Valeroa1a2 c1, Eva Maria Navarrete-Muñoza1a2, Marisa Rebagliatoa2, Carmen Iñigueza2a3, Mario Murciaa2a3, Alfredo Marcoa2a4, Ferran Ballestera2a3 and Jesus Vioquea1a2

a1 Departamento de Salud Pública, Campus San Juan, Universidad Miguel Hernández, Carretera de Valencia s/n, 03550 San Juan de Alicante, Spain

a2 CIBER Epidemiología y Salud Pública (CIBERESP), Spain

a3 Centro Superior de Investigación en Salud Pública (CSISP), Valencia, Spain

a4 Hospital La Fe, Valencia, Spain


We examined the relationship between dietary folate intake and periconceptional use of folic acid (FA) supplements, and small-for-gestational age for weight (SGA-W) and height (SGA-H). The study is based on 786 Spanish women aged 16 years or above, who attended the first-term prenatal population-based screening programme (10–13 weeks) at the reference hospital ‘La Fe’, Valencia, with singleton pregnancy. Periconceptional use of FA supplements was categorised as non-users, moderate users ( ≤ 1 mg/d) and high users (>1 mg/d). Babies born to mothers who used high doses of FA supplements had a significant reduction in mean birth height compared with babies of non-users (β = − 0·53, 95 % CI − 0·96, − 0·09). As regards weight, mothers using moderate and high doses of FA supplements had lower-birth-weight babies for gestational age than non-users (β = − 22·96, 95 % CI − 101·14, 55·23; β = − 89·72, 95 % CI − 188·64, 9·21, respectively), although these decreases were not significant. Results from the multivariate logistic regression models showed that high FA supplement users had a higher significant risk for SGA-H (OR 5·33, 95 % CI 2·08, 13·7), and that users of moderate doses were not associated with a higher risk of either a SGA-W or a SGA-H baby. In contrast, increased quintiles of the dietary intake of folate were associated with a decreased risk of SGA-W (P for trend = 0·002), although no association was observed for SGA-H. Our findings suggest that periconceptional use of FA supplements greater than 1 mg/d is associated with decreased birth height and may entail a risk of decreased birth weight.

(Received February 10 2010)

(Revised November 10 2010)

(Accepted November 12 2010)

(Online publication January 28 2011)


c1 Corresponding author: M. Pastor-Valero, fax +34 96591955; email


Abbreviations: FA, folic acid; SGA, small-for-gestational age; SGA-H, small-for-gestational age for height; SGA-W, small-for-gestational age for weight