Timing of high-dose folic acid supplementation in the periconceptional period among women taking antiseizure medications and risk of major congenital anomalies: a target trial emulation - PubMed
8 hours ago
- #Antiseizure Medications
- #Congenital Anomalies
- #Folic Acid Supplementation
- High-dose folic acid supplementation is recommended for women on antiseizure medications (ASMs) to reduce major congenital anomalies (MCAs) risk in offspring.
- Initiating high-dose folic acid (4 or 5 mg/day) 1-12 weeks before pregnancy was associated with a significant 45% relative risk reduction (RR=0.55) and an absolute risk reduction of 2.2 percentage points in MCAs.
- No risk reduction was observed when folic acid was initiated 1-12 weeks after pregnancy (RR=1.27) or 13-52 weeks before pregnancy (RR=0.99).
- The study emulated a target trial using Nordic registry data from 1997-2020, including thousands of eligible pregnancies across three periconceptional periods.