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Effect of Folate Intake on Health Outcomes in Pregnancy

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Micronutrients and Human Health".

Deadline for manuscript submissions: closed (15 January 2021) | Viewed by 13350

Special Issue Editors


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Guest Editor
1. Department of Biomedicine–Unit of Biochemistry, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
2. CINTESIS@RISE, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
Interests: nutrition; metabolism; pregnancy; fetal programing; micronutrientes
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Guest Editor
CBQF - Centro de Biotecnologia e Química Fina – Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Porto, Portugal
Interests: nutrition; supplementation; fortification; public health; pregnancy

Special Issue Information

Dear Colleagues,

Folates are a family of water soluble B-vitamins which are required for one carbon metabolism, being thus essential for the synthesis of several aminoacids, thymidylate, and purines and also the universal methyl donor S-adenosyl-methionine. Thus, an adequate folate status is critical for nucleic acid synthesis and hence for cell division, for catecholamine metabolism, and also for epigenetic regulation of gene expression. 

Folate inadequacy resulting from deficient or excessive intakes are up-to-date concerns.

On the one hand, poor nutrition, intestinal malabsorption, dysbiosis, and conditions associated with increased needs, such as pregnancy, may precipitate folate deficiency, which is considered the most prevalent vitamin deficiency in the western world. On the other hand, public health practices such as generalized folate fortification of staple foods and clinical recommendation of folate supplementation during pregnancy may result in folate excessive intake.

Importantly, health concerns arise from both folate deficiency and excess. While folate deficiency is well known to increase the risk of a series of conditions or diseases, such as cardiovascular disease, stroke, mental diseases, cancer, and neural tube defects, folate excess has been associated with masking vitamin B12 deficiency, promotion of cancer and, more recently, fetal programming of metabolic disease.

Robust evidence regarding the molecular mechanisms of folate prevention of neural tube defects, or evidence on fetal programming effects of excessive or deficient folate intake is still lacking.

This Special Issue aims to gather scientific updates about the health impact of folate adequate, excessive or deficient status on pregnancy, fetal or neonatal health. In addition, evidence on folate public health practices and characterization of compliance to clinical guidelines is also in the scope of this special issue. Contributions may take the form of original articles or reviews of the literature, systematic reviews, and meta-analyses.

Prof. Elisa Keating
Prof. Elisabete Pinto
Guest Editors

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Keywords

  • Folate
  • Pregnancy
  • Supplementation
  • Fortification
  • Fetal programming
  • Public health policy

Published Papers (4 papers)

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Research

13 pages, 298 KiB  
Article
Effectiveness of Folic Acid Supplementation Recommendations among Polish Female Students from the Podkarpackie Region
by Maria Zadarko-Domaradzka, Ewa Kruszyńska and Emilian Zadarko
Nutrients 2021, 13(3), 1001; https://doi.org/10.3390/nu13031001 - 19 Mar 2021
Cited by 4 | Viewed by 2653
Abstract
Adequate folic acid supplementation during the preconception period is an important element in the primary prevention of neural tube defects (NTDs). This study aims to study the effectiveness of folic acid supplementation recommendations among women of childbearing age, and to assess and characterise [...] Read more.
Adequate folic acid supplementation during the preconception period is an important element in the primary prevention of neural tube defects (NTDs). This study aims to study the effectiveness of folic acid supplementation recommendations among women of childbearing age, and to assess and characterise their awareness about this public health measure. The cross-sectional study included women (N = 1285) aged 22.27 ± 4.6 years old on average. Some of the results were obtained on a subgroup of women (N = 1127) aged 21.0 ± 2.1. This study was performed using a questionnaire. The analysis was performed with the use of a logistic regression model, chi-square test for independence and odds ratio (OR). According to the results, only 13.9% of women supplement folic acid, and 65.3% of them do so daily. A total of 91.1% of the respondents were not aware of its recommended dose and 43% did not know the role it plays in the human body. Among women who do not currently supplement folic acid (N = 1052), 52.4% declared doing so while planning their pregnancy. Women’s awareness about the role of folic acid in NTD prevention (OR = 4.58) and the information they got from physicians (OR = 1.68) are key factors that increased the odds of the women taking folic acid before pregnancy. There is therefore a need for more information and education campaigns to raise awareness about folic acid. Full article
(This article belongs to the Special Issue Effect of Folate Intake on Health Outcomes in Pregnancy)
15 pages, 311 KiB  
Article
Methylenetetrahydrofolate Reductase (MTHFR) Gene Polymorphism and Infant’s Anthropometry at Birth
by Sofía Aguilar-Lacasaña, Inmaculada López-Flores, Beatriz González-Alzaga, María José Giménez-Asensio, F. David Carmona, Antonio F. Hernández, María Felicidad López Gallego, Desirée Romero-Molina and Marina Lacasaña
Nutrients 2021, 13(3), 831; https://doi.org/10.3390/nu13030831 - 3 Mar 2021
Cited by 10 | Viewed by 2776
Abstract
Identification of causal factors that influence fetal growth and anthropometry at birth is of great importance as they provide information about increased risk of disease throughout life. The association between maternal genetic polymorphism MTHFR(677)C>T and anthropometry at birth has been widely studied because [...] Read more.
Identification of causal factors that influence fetal growth and anthropometry at birth is of great importance as they provide information about increased risk of disease throughout life. The association between maternal genetic polymorphism MTHFR(677)C>T and anthropometry at birth has been widely studied because of its key role in the one-carbon cycle. MTHFR(677) CT and TT genotypes have been associated with a greater risk of low birth weight, especially in case of deficient intake of folic acid during pregnancy. This study aimed to analyze the association between the maternal MTHFR(677)C>T genetic polymorphism and anthropometry at birth in a population with adequate folate consumption. We included 694 mother–newborn pairs from a prospective population-based birth cohort in Spain, in the Genetics, Early life enviroNmental Exposures and Infant Development in Andalusia (GENEIDA) project. Women were genotyped for MTHFR(677)C>T SNP by Q-PCR using TaqMan© probes. Relevant maternal and newborn information was obtained from structured questionnaires and medical records. Results showed that maternal MTHFR(677)C>T genotype was associated with newborn anthropometry. Genotypes CT or CT/TT showed statistically significant associations with increased or decreased risk of large-for-gestational-age (LGA) or small-for-gestational-age (SGA) based on weight and height, depending on the newborn’s sex, as well as with SGA in premature neonates. The relationships between this maternal genotype and anthropometry at birth remained despite an adequate maternal folate intake. Full article
(This article belongs to the Special Issue Effect of Folate Intake on Health Outcomes in Pregnancy)
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11 pages, 1163 KiB  
Article
Periconceptional Folic Acid Supplementation and the Risk of Spontaneous Abortion among Women Who Prepared to Conceive: Impact of Supplementation Initiation Timing
by Yan-Yan Mao, Liu Yang, Min Li, Jun Liu, Qian-Xi Zhu, Yang He and Wei-Jin Zhou
Nutrients 2020, 12(8), 2264; https://doi.org/10.3390/nu12082264 - 29 Jul 2020
Cited by 15 | Viewed by 2935
Abstract
It is unclear whether periconceptional folic acid (FA) supplementation decreases the risk of spontaneous abortion (SA). The impact of supplementation initiation timing has not been ascertained. This cohort study aimed to investigate the association between maternal periconceptional FA supplementation and risk of SA, [...] Read more.
It is unclear whether periconceptional folic acid (FA) supplementation decreases the risk of spontaneous abortion (SA). The impact of supplementation initiation timing has not been ascertained. This cohort study aimed to investigate the association between maternal periconceptional FA supplementation and risk of SA, with due consideration of the supplementation initiation timing. Through the National Free Pre-conception Health Examination Project (NFPHEP), we identified 65,643 pregnancies on FA supplementation in Chongqing, China between 2010 and 2015. After adjusting for covariates, maternal periconceptional FA supplementation was associated with a lower risk of SA (adjusted risk ratio [aRR]: 0.52; 95% confidence interval [CI]: 0.48–0.56). Pregnant women with FA supplementation initiated at least 3 months before conception had a 10% lower risk of SA (aRR: 0.46; 95% CI: 0.42–0.50) than those with FA supplementation initiated 1–2 months before conception (aRR: 0.56; 95% CI: 0.50–0.62) or after conception (aRR: 0.56; 95% CI: 0.51–0.61). These associations might not thoroughly account for FA supplementation, and to some extent our findings confirm the role of the utilization of healthcare in preventing SAs. Women who initiated healthcare, including taking FA earlier during the periconceptional period, could have a lower risk of SA. Full article
(This article belongs to the Special Issue Effect of Folate Intake on Health Outcomes in Pregnancy)
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14 pages, 819 KiB  
Article
Distribution of 5-Methyltetrahydrofolate and Folic Acid Levels in Maternal and Cord Blood Serum: Longitudinal Evaluation of Japanese Pregnant Women
by Yoshinori Kubo, Hideoki Fukuoka, Terue Kawabata, Kumiko Shoji, Chisato Mori, Kenichi Sakurai, Masazumi Nishikawa, Takeshi Ohkubo, Kyoichi Oshida, Naotake Yanagisawa and Yuichiro Yamashiro
Nutrients 2020, 12(6), 1633; https://doi.org/10.3390/nu12061633 - 1 Jun 2020
Cited by 13 | Viewed by 4056
Abstract
“Total” folate in blood has usually been measured to evaluate the folate status of pregnant women. However, folate is composed of many metabolites. The main substrate is 5-methyltetrahydrofolate (5-MTHF), with folic acid (FA) representing a very small component as an unmetabolized species in [...] Read more.
“Total” folate in blood has usually been measured to evaluate the folate status of pregnant women. However, folate is composed of many metabolites. The main substrate is 5-methyltetrahydrofolate (5-MTHF), with folic acid (FA) representing a very small component as an unmetabolized species in blood. We longitudinally evaluated 5-MTHF, FA and total homocysteine in maternal and cord blood from Japanese pregnant women. Subjects were 146 pregnant women who participated in the Chiba study of Mother and Child Health (C-MACH) prospective cohort study. Sera were obtained in early and late pregnancy, at delivery, and from cord blood. Species levels were measured by isotope-dilution mass spectrometry. Both 5-MTHF and FA levels were lower than reported levels from pregnant women in populations from countries with mandatory FA fortification. As gestational age progressed, serum 5-MTHF levels decreased, whereas serum FA levels were slightly reduced only at delivery compared to early pregnancy. A significant negative association between serum 5-MTHF and total homocysteine was shown at all examined times, but no associations with FA were evident. At delivery, cord 5-MTHF was significantly higher than maternal levels, while FA again showed no significant correlation. These results suggest that 5-MTHF is actively transported to the fetus through placental transporters and may reflect folate status during pregnancy as a physiologically important species. Full article
(This article belongs to the Special Issue Effect of Folate Intake on Health Outcomes in Pregnancy)
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