High dose folic acid supplements beyond the first trimester of pregnancy do not prevent pre-eclampsia in women at high risk for the condition, according to results of a new trial published in the BMJ.
The international Folic Acid Clinical Trial (FACT) included pregnant women attending obstetrical centres in Argentina, Australia, Canada, Jamaica, and the UK. A total of 2,301 participants, who each had at least one high risk factor for pre-eclampsia, were randomised to receive 4.0 mg of folic acid or placebo, taken as four 1.0 mg tablets once daily, from randomisation at 8-16 completed weeks of gestation, until delivery.
Pre-eclampsia occurred in 14.8 per cent of women in the folic acid group and 13.5 per cent in the placebo group. There was no evidence of differences between the groups for any other adverse maternal or neonatal outcomes.
Writing in the BMJ, the authors said the finding of a “lack of demonstrated benefit of high dose folic acid supplementation beyond the first trimester for women at high risk of developing pre-eclampsia indicates that high dose recommendation should now cease, and the search for an effective and acceptable strategy to prevent pre-eclampsia must continue”.