Shamila Ijaz Munir, Mariam Riaz, Yasmeen M Din, Amna Ahsan, Saira Fayyaz.
Folic acid supplementation for prevention of preterm delivery in females presenting in third trimester of pregnancy.
J Allama Iqbal Med Coll Jan ;19(4):858-62.

Background: Preterm birth complicates 12% of deliveries and accounts for many fetal anomalies. During pregnancy, fetal growth causes an increase in the total number of rapidly dividing cells, which leads to increased requirements for folate and subsequent decrease in serum folate concentration which has been proposed as trigger for preterm delivery. Many recent studies claimed that folic acid supplementation in pregnant women during 3rd trimester resulted in considerably lower frequency of preterm delivery and advocated routine folic acid supplementation in future. Objective: The objective of this study is to determine the frequency of preterm delivery with folic acid supplementation in females presenting during third trimester of pregnancy. Methods: This study is descriptive case series and was conducted in Obstetrics and Gynaecology department of Sir Ganga Ram Hospital, Lahore from 1st September, 2019 to 28th Feb,2020. Total of 170 pregnant women aged between 18-40 years presenting between 24-28 weeks of gestation were enrolled after informed consent. These patients were advised to take folic acid 5mg/day until delivery. Outcome variable was frequency of preterm delivery which was labeled if the delivery occurred before 37 completed weeks of gestation as calculated from last menstrual period. Results: The mean age was 26.7±4.9 years. There were 139 (81.8%) primiparas and 31 (18.2%) multiparas. The mean gestational age was 26.0±1.4 weeks while the mean BMI was 24.5±3.3 Kg/m2. Preterm delivery occurred in 11 (6.5%) patients. There was no statistically significant difference in the frequency of preterm delivery across various subgroups based on patient's age (p-value=0.999), parity (p-value=0.996), gestational age (p-value=0.959) and BMI (p-value=0.896). Conclusion: Folic acid supplementation in pregnant women in 3rd trimester decreases the occurrence of preterm delivery along with associated maternal and neonatal morbidity. Key Words: Preterm Delivery, Folic Acid, 3rd Trimester.

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