A prospective cohort study depicted that when it comes to twin pregnancies, the utilization of maternal preconceptional folic acid supplementation was correlated with an extended gestational duration and a reduced hazard of preterm birth occurring prior to 36 weeks and experiencing premature rupture of membranes (PROM). Yuanqing Xia et al. aimed to investigate how maternal preconceptional folic acid use might be linked to gestational age at delivery and the risk of preterm birth.

Researchers also examined whether this link differed based on factors like chorionicity and conception mode. Data on folic acid supplementation and pregnancy outcomes were gathered from women expecting twins. They employed both linear and logistic regression models to assess how preconceptional folic acid supplementation was related to PROM, preterm birth, and gestational age at delivery.

The study encompassed 416 twin pregnancies. In comparison to twins whose mothers did not use preconceptional folic acid, those whose mothers did had a 0.385-week longer gestational age and a reduced risk of preterm birth before 36 weeks (adjusted odds ratio 0.519) and PROM (adjusted odds ratio 0.426). This protective effect against preterm birth and PROM was consistent whether mothers took folic acid supplements alone or multivitamins.

Nonetheless, the connections between preconceptional folic acid usage and pregnancy outcomes showed variations depending on compliance with supplementation, conception mode, and chorionicity. The favorable relationship between preconceptional folic acid usage and longer gestational age remained statistically significant for twins conceived through assisted reproductive technology or those classified as dichorionic diamniotic twins.

Notably, substantial protective effects against preterm birth before 36 weeks and PROM were solely observed in women who had taken folic acid supplements at least four times a week before conception. Therefore, maternal preconceptional folic acid supplementation was beneficial for twin pregnancies. For women planning to conceive, it is advisable to begin taking folic acid supplements well in advance and maintain consistent compliance to enhance their chances of a successful pregnancy.