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Periconceptional folic acid supplementation and anthropometric measures at birth in a cohort of pregnant women in Valencia, Spain

  • Maria Pastor-Valero (a1) (a2), Eva Maria Navarrete-Muñoz (a1) (a2), Marisa Rebagliato (a2), Carmen Iñiguez (a2) (a3), Mario Murcia (a2) (a3), Alfredo Marco (a2) (a4), Ferran Ballester (a2) (a3) and Jesus Vioque (a1) (a2)...
Abstract

We examined the relationship between dietary folate intake and periconceptional use of folic acid (FA) supplements, and small-for-gestational age for weight (SGA-W) and height (SGA-H). The study is based on 786 Spanish women aged 16 years or above, who attended the first-term prenatal population-based screening programme (10–13 weeks) at the reference hospital ‘La Fe’, Valencia, with singleton pregnancy. Periconceptional use of FA supplements was categorised as non-users, moderate users ( ≤ 1 mg/d) and high users (>1 mg/d). Babies born to mothers who used high doses of FA supplements had a significant reduction in mean birth height compared with babies of non-users (β = − 0·53, 95 % CI − 0·96, − 0·09). As regards weight, mothers using moderate and high doses of FA supplements had lower-birth-weight babies for gestational age than non-users (β = − 22·96, 95 % CI − 101·14, 55·23; β = − 89·72, 95 % CI − 188·64, 9·21, respectively), although these decreases were not significant. Results from the multivariate logistic regression models showed that high FA supplement users had a higher significant risk for SGA-H (OR 5·33, 95 % CI 2·08, 13·7), and that users of moderate doses were not associated with a higher risk of either a SGA-W or a SGA-H baby. In contrast, increased quintiles of the dietary intake of folate were associated with a decreased risk of SGA-W (P for trend = 0·002), although no association was observed for SGA-H. Our findings suggest that periconceptional use of FA supplements greater than 1 mg/d is associated with decreased birth height and may entail a risk of decreased birth weight.

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*Corresponding author: M. Pastor-Valero, fax +34 96591955; email mpastor@umh.es
References
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1Laurence K, James N, Miller M, et al. (1980) Increased risk of recurrence of pregnancies complicated by fetal neural tube defects in mothers receiving poor diets, and possible benefit of dietary counselling. Br Med J 281, 15921594.
2Laurence K, James N, Miller M, et al. (1981) Double-blind randomised controlled trial of folate treatment before conception to prevent recurrence of neural-tube defects. Br Med J 282, 15091511.
3Mulinare J, Cordero J, Erickson J, et al. (1988) Periconceptional use of multivitamins and the occurrence of neural tube defects. JAMA 260, 31413145.
4Milunsky A, Jick H, Jick S, et al. (1989) Multivitamin/folic acid supplementation in early pregnancy reduces the prevalence of neural tube defects. JAMA 262, 28472852.
5Bower C & Stanley F (1989) Dietary folate as a risk factor for neural-tube defects: evidence from a case–control study in Western Australia. Med J Aust 150, 613619.
6Mills J, Rhoads G, Simpson J, et al. (1989) The absence of a relation between the periconceptional use of vitamins and neural-tube defects. National Institute of Child Health and Human Development Neural Tube Defects Study Group. N Engl J Med 321, 430435.
7Vergel R, Sanchez L, Heredero B, et al. (1990) Primary prevention of neural tube defects with folic acid supplementation: Cuban experience. Prenat Diagn 10, 149152.
8MRC Vitamin Study Research Group (1991) Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. Lancet 338, 131137.
9Czeizel A & Dudás I (1992) Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med 327, 18321835.
10Czeizel A (1993) Prevention of congenital abnormalities by periconceptional multivitamin supplementation. BMJ 306, 16451648.
11Werler M, Shapiro S & Mitchell A (1993) Periconceptional folic acid exposure and risk of occurrent neural tube defects. JAMA 269, 12571261.
12Shaw G, Schaffer D, Velie E, et al. (1995) Periconceptional vitamin use, dietary folate, and the occurrence of neural tube defects. Epidemiology 6, 219226.
13Eichholzer M, Tönz O & Zimmermann R (2006) Folic acid: a public-health challenge. Lancet 367, 13521361.
14Tamura T & Picciano M (2006) Folate and human reproduction. Am J Clin Nutr 83, 9931016.
15Baumslag NET & Metz J (1970) Reduction of incidence of prematurity by folic acid supplementation in pregnancy. Br Med J 1, 1617.
16Rolschau JDJ & Kristoffersen K (1979) Folic acid supplement and intrauterine growth. Acta Obstet Gynecol Scand 58, 343346.
17Goldenberg R, Tamura T, Cliver S, et al. (1992) Serum folate and fetal growth retardation: a matter of compliance? Obstet Gynecol 79, 719722.
18Scholl T, Hediger M & Schall J (1996) Dietary and serum folate: their influence on the outcome of pregnancy. Am J Clin Nutr 63, 520525.
19Neggers Y, Goldenberg R & Tamura T (1997) The relationship between maternal dietary intake and infant birthweight. Acta Obstet Gynecol Scand Suppl 165, 7175.
20Mitchell E, Robinson E, Clark P, et al. (2004) Maternal nutritional risk factors for small for gestational age babies in a developed country: a case–control study. Arch Dis Child Fetal Neonatal 89, 431435.
21van Eijsden M, Smits L & van der Wal M (2008) Association between short interpregnancy intervals and term birth weight: the role of folate depletion. Am J Clin Nutr 88, 147153.
22Shaw G, Carmichael S, Nelson V, et al. (2004) Occurrence of low birthweight and preterm delivery among California infants before and after compulsory food fortification with folic acid. Public Health Rep 119, 170173.
23Shaw G, Liberman R, Todoroff K, et al. (1997) Low birth weight, preterm delivery, and periconceptional vitamin use. J Pediatr 130, 10131014.
24Mathews F, Yudkin P & Neil A (1999) Influence of maternal nutrition on outcome of pregnancy: prospective cohort study. BMJ 319, 339343.
25Rondo P & Tomkins A (2000) Folate and intrauterine growth retardation. Ann Trop Paediatr 20, 253258.
26Charles D, Ness A & Campbell D (2005) Folic acid supplements in pregnancy and birth outcome: re-analysis of a large randomised controlled trial and update of Cochrane review. Paediatr Perinat Epidemiol 19, 112124.
27Rolschau J, Kristoffersen K, Ulrich MT, et al. (1999) The influence of folic acid supplement on the outcome of pregnancies in the county of Funen in Denmark. Eur J Obstet Gynecol Reprod Biol 87, 105110, discussion 3–4.
28Timmermans S, Jaddoe V, Hofman A, et al. (2009) Periconception folic acid supplementation, fetal growth and the risks of low birth weight and preterm birth: the Generation R Study. Br J Nutr 102, 777785.
29Lucock M (2004) Is folic acid the ultimate functional food component for disease prevention ? BMJ 328, 211214.
30Lucock M & Yates Z (2005) Folic acid – vitamin and panacea or genetic time bomb? Nat Rev Genet 6, 235240.
31Martínez-Frías M, Rodríguez-Pinilla E & Bermejo E (2003) Analysis of the Spanish situation regarding folic acid/calcic folinate consumption for birth defects prevention. Med Clin 121, 772775.
32Martínez-Frías M (2007) Folic acid dose in the prevention of congenital defects. Med Clin 128, 609616.
33Ribas-Fitó N, Ramón R, Ballester F, et al. (2006) Child health and the environment: the INMA Spanish Study. Paediatr Perinat Epidemiol 20, 403410.
34Ramón R, Ballester F, Aguinagalde X, et al. (2009) Fish consumption during pregnancy, prenatal mercury exposure, and anthropometric measures at birth in a prospective mother–infant cohort study in Spain. Am J Clin Nutr 90, 10471055.
35Ramón R, Ballester F, Iñiguez C, et al. (2009) Vegetable but not fruit intake during pregnancy is associated with newborn anthropometric measures. J Nutr 139, 561567.
36Carrascosa A, Yeste D, Copil A, et al. (2004) Secular growth changes. Weight, height and body mass index values in infant, children, adolescent and young adults from Barcelona population. Med Clin 123, 445451.
37Willett W, Sampson L, Stampfer M, et al. (1985) Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 122, 5165.
38Vioque J (2006) Validez de la evaluación de la ingesta dietética (Validity of dietary intake assessment). In Nutrición y Salud Pública Métodos, Bases Científicas y Aplicaciones (Nutrition and Public Health Methods, Scientific Bases and Applications), pp. 199210 [Serra-Manjem LA and Aranceta Bartrina, editors J]. Barcelona: Masson-Elsevier.
39Vioque J, Weinbrenner T, Asensio L, et al. (2007) Plasma concentrations of carotenoids and vitamin C are better correlated with dietary intake in normal weight than overweight and obese elderly subjects. Br J Nutr 97, 977986.
40US Department of Agriculture & Agricultural Research Service (2007) USDA National Nutrient Database for Standards Reference, Release 20. http://www.ars.usda.gov/ba/bhnrc/hdl41.
41Rodríguez-Bernal CL, Rebagliato M, Iñiguez C, et al. (2010) Diet quality in early pregnancy and its effects on fetal growth outcomes: the Infancia y Medio Ambiente (Childhood and Environment) Mother and Child Cohort Study in Spain. Am J Clin Nutr 91, 16591666.
42Bailey S & Ayling J (2009) The extremely slow and variable activity of dihydrofolate reductase in human liver and its implications for high folic acid intake. Proc Natl Acad Sci U S A 106, 1542415429.
43Sweeney M, Staines A, Daly L, et al. (2009) Persistent circulating unmetabolised folic acid in a setting of liberal voluntary folic acid fortification. Implications for further mandatory fortification? BMC Public Health 9, 295.
44Cole B, Baron J, Sandler R, et al. (2007) Folic acid for the prevention of colorectal adenomas: a randomized clinical trial. JAMA 297, 23512359.
45Figueiredo J, Grau M, Haile R, et al. (2009) Folic acid and risk of prostate cancer: results from a randomized clinical trial. J Natl Cancer Inst 101, 432435.
46Steegers-Theunissen R, Obermann-Borst S, Kremer D, et al. (2009) Periconceptional maternal folic acid use of 400 microg per day is related to increased methylation of the IGF2 gene in the very young child. PLoS One 16, e7845.
47Zeisel S (2009) Importance of methyl donors during reproduction. Am J Clin Nutr 89, 673S677S.
48Wen S, Zhou J, Yang Q, et al. (2008) Maternal exposure to folic acid antagonists and placenta-mediated adverse pregnancy outcomes. CMAJ 179, 12631268.
49Hennekens CH & Buring JE (1987) Epidemiology in Medicine. Boston, MA: Little, Brown and Co.
50Hernán M, Hernández-Díaz S & Robins J (2004) A structural approach to selection bias. Epidemiology 15, 615625.
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British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
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