Relationship between dietary folate intakes, maternal plasma total homocysteine and B-vitamins during pregnancy and fetal growth in Japan
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Adequate folate status in pregnancy is important for satisfactory pregnancy outcome.
Aim of the Study
The objective of the present study was to evaluate folate status in healthy pregnant women by assessing dietary folate intakes and measuring changes in folate-related biomarkers including plasma tHcy, serum vitamin B12 (B12), and serum and RBC folate concentrations in each trimester and to examine their relation to fetal growth.
From 94 pregnant women, 3-day-dietary records were obtained and blood was collected for plasma total homocysteine (tHcy), serum B12, and serum and red-blood cell (RBC) folate measurements. Infant anthropometric measurements were made immediately after birth.
Average folate intake was less than 300 µg/day with a mean energy intake of about 1800 kcal. Mean serum and RBC folate concentrations declined significantly during gestation (p < 0.05). Mean serum B12 also significantly decreased (p < 0.01), whereas plasma tHcy increased from 5.1 in the first trimester to 5.9 µmol/l in the third trimester (p < 0.01). Multiple regression analyses, after controlling for maternal age, parity and pre-pregnancy body-mass index indicated that a 1.0 µmol/l increase in plasma tHcy in the third trimester corresponded to a 151 g decrease in birth weight (p < 0.01). Neither B12 nor folate concentrations in all three trimesters showed any significant associations with birthweight. Plasma pyridoxal-5′-phosphate concentrations were markedly low, and were consistent with low intake of vitamin B6 in our population.
Our data suggest that higher plasma tHcy in the third trimester is a predictor of lower birth weight. In general, the dietary intake of B-vitamins and energy may be inadequate in our population, suggesting intervention is necessary.
Keywordspregnancy folate homocysteine fetal growth neonatal anthropometric measures
Sponsorship: This study was supported by the Ministry of Health, Labour, and Welfare, Health and Labour Research Grant, Research on Children and Families. We thank Ms. Yukari Tamagawa, Ms. Chiharu Ninakawa, and Ms. Soko Nakagami for checking and coding dietary data. There are no conflicts of interest regarding any of the authors. Authors’ contributions: HT was involved in planning and coordinating of the study, data collection and statistical analysis, and the writing of the paper. NM contributed to data collection and analysis of the overall study. KU was the supervisor and coordinator of all analyses. AI and KK were involved in data collection and analysis of dietary data. SA, MY, HF, and CO were responsible for selection of patients, and contributed to data collection. NY designed the study, and was the overall supervisor of the project.
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