Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #115352

Lorraine Yeung, MD, MPH¹, Jianmeng Liu, MD, PhD², Jacqueline Gindler, MD¹, Zhu Li, MD², RJ Berry, MD, MPHTM¹, and Junchi Zheng, MD². (1) National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-86, Atlanta, GA 30333, 404-498-3824, Lcy5@cdc.gov, (2) The National Center for Maternal and Infant Health and the Department of Health Care Epidemiology, Peking University Health Science Center, 38 College Road, Beijing, 100083, China

Background: Periconcepional use of folic acid (FA) reduces a woman's chance of having a pregnancy affected by a neural tube defect (NTD). Few studies have evaluated other health effects among children whose mothers took FA during early pregnancy. A public health campaign to use folic acid to reduce NTDs in China provided an opportunity to study the association between maternal use of FA supplements before and during early pregnancy and infant mortality. Methods: We established prospective follow-up of women who had a premarital examination and delivered a singleton, live-born child. We then determined the number of these children who had died during infancy. We calculated infant and postneonatal mortality rates (IMR and PNNMR) among women who did and did not take 0.4mg of FA before and during early pregnancy. We used multivariate analyses to adjust for potential confounders. Results: Among the 131,564 infants, 1,342 infant deaths occurred (10.2/1,000 live births). Among the infants of the 106,375 women who took FA and 25,216 women who did not, the IMRs were 10.0 and 11.1, respectively, RR=0.90, 95% CI=0.79-1.02, and the PNNMRs were 2.5 and 3.3, respectively, RR=0.75, 95% CI=0.59-0.96. Adjusting for potential confounders did not significantly change these results. Conclusions: In this population-based study, we found a lower risk of postneonatal mortality among infants whose mothers took FA supplements before and during early pregnancy. However, because FA supplementation did not occur during the second and third trimesters, such an FA effect on infant mortality would occur before or during the first trimester.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• State the infant mortality rate in the People's Republic of China.
• Describe the public health campaign to use folic acid to reduce neural tube defects in the People’s Republic of China.
• Recognize the possible role of folic acid in the reduction of infant mortality.

Keywords: Infant Mortality, Nutrition

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.