title: Association of folic acid supplementation during pregnancy and infant bronchiolitis.
abstract: Viral bronchiolitis affects 20%-30% of infants; because there is no known effective treatment, it is important to identify risk factors that contribute to its pathogenesis. Although adequate folate intake during the periconceptional period prevents neural tube defects, animal data suggest that higher supplementation may be a risk factor for child respiratory diseases. Using a population-based retrospective cohort of 167,333 women and infants, born in 1995-2007 and enrolled in the Tennessee Medicaid program, we investigated the association between the filling of folic acid-containing prescriptions and infant bronchiolitis. We categorized women into the following 4 groups in relation to the first trimester: "none" (no prescription filled), "first trimester only," "after first trimester," and "both" (prescriptions filled both during and after the first trimester). Overall, 21% of infants had a bronchiolitis diagnosis, and 5% were hospitalized. Most women filled their first prescriptions after the fifth to sixth weeks of pregnancy, and most prescriptions contained 1,000 µg of folic acid. Compared with infants born to women in the "none" group, infants born to women in the "first trimester only" group had higher relative odds of bronchiolitis diagnosis (adjusted odds ratio = 1.17, 95% confidence interval: 1.11, 1.22) and greater severity (adjusted odds ratio = 1.16, 95% confidence interval: 1.11, 1.22). This study's findings contribute to an understanding of the implications of prenatal nutritional supplement recommendations for infant bronchiolitis.
authors.forename: Sreenivas P
authors.initials: SP
authors.lastname: Veeranki
authors.forename: Tebeb
authors.initials: T
authors.lastname: Gebretsadik
authors.forename: Stacy L
authors.initials: SL
authors.lastname: Dorris
authors.forename: Edward F
authors.initials: EF
authors.lastname: Mitchel
authors.forename: Tina V
authors.initials: TV
authors.lastname: Hartert
authors.forename: William O
authors.initials: WO
authors.lastname: Cooper
authors.forename: Frances A
authors.initials: FA
authors.lastname: Tylavsky
authors.forename: William
authors.initials: W
authors.lastname: Dupont
authors.forename: Terryl J
authors.initials: TJ
authors.lastname: Hartman
authors.forename: Kecia N
authors.initials: KN
authors.lastname: Carroll
mesh_terms: D000293:Adolescent; D000328:Adult; D001990:Bronchiolitis, Viral / Q000175:diagnosis / Q000209:etiology*; D015331:Cohort Studies; D019587:Dietary Supplements / Q000009:adverse effects*; D005260:Female; D005492:Folic Acid / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D009436:Neural Tube Defects / Q000517:prevention & control; D016017:Odds Ratio; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011295:Prenatal Care; D011297:Prenatal Exposure Delayed Effects / Q000209:etiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014803:Vitamin B Complex / Q000009:adverse effects* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D014803:Vitamin B Complex; D005492:Folic Acid
keywords: Medicaid; bronchiolitis; folate; folic acid supplementation; pregnancy; prenatal vitamin