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Epidemiological evidence suggests that maternal folic acid supplementation may play a role in preventing other adverse birth outcomes. This systematic review aimed to investigate the effect of maternal folic acid supplementation during pregnancy on risk of preeclampsia and gestational hypertension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multiple scientific databases and grey literature were searched for relevant studies. Studies were reviewed according to pre\u2010specified inclusion and exclusion criteria. Study characteristics were summarised and study quality was assessed. A meta\u2010analysis of observational studies was conducted to examine the effect of maternal folic acid supplementation on preeclampsia risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Meta\u2010analysis of eight observational studies showed significantly lower odds of preeclampsia with folic acid supplementation in comparison to no folic acid supplementation: <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a00.78 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.63, 0.98), with moderately high heterogeneity between studies. Subgroup analysis showed no significant subgroup difference between folic acid supplementation taken by itself, in comparison to folic acid taken in or alongside a multivitamin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Low level evidence is available for a modest association between maternal folic acid supplementation and reduction in preeclampsia risk. Future studies should differentiate between early and late onset and mild vs severe preeclampsia, and should control for relevant confounders including the presence of multivitamin supplements.<\/jats:p><jats:p>The protocol for this systematic review was prospectively registered with PROSPERO (CRD42015029310).<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12476","type":"journal-article","created":{"date-parts":[[2018,6,8]],"date-time":"2018-06-08T14:16:14Z","timestamp":1528467374000},"page":"346-357","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Maternal folic acid supplementation for the prevention of preeclampsia: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3765-1387","authenticated-orcid":false,"given":"Rhodi E.","family":"Bulloch","sequence":"first","affiliation":[{"name":"The Discipline of Nutrition and Dietetics School of Medical and Health Sciences The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1708-9633","authenticated-orcid":false,"given":"Amy L.","family":"Lovell","sequence":"additional","affiliation":[{"name":"The Discipline of Nutrition and Dietetics School of Medical and Health Sciences The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9079-6457","authenticated-orcid":false,"given":"Vanessa M. 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