European Journal of Nutrition

, Volume 47, Issue 6, pp 341–347

Dietary folate intake during pregnancy and birth weight in Japan

  • Hiroko Watanabe
  • Hideoki Fukuoka
  • Takashi Sugiyama
  • Yasushi Nagai
  • Kayoko Ogasawara
  • Nobuo Yoshiike
ORIGINAL CONTRIBUTION

Abstract

Background

Inadequate folate status has been associated with many negative reproductive outcomes, such as neural tube defects (NTD), low birth weight and placental abruption.

Aim of the study

The objectives of this study were to evaluate the levels of dietary folate intake during pregnancy in Japanese women and the subsequent birth weight of their babies.

Methods

A longitudinal prospective study was conducted with 197 women with a singleton pregnancy in 2005. Dietary folate was investigated 3 times: in the first trimester at 12 weeks, in the second trimester at 20 weeks and in third trimester at 32 weeks using a diet history questionnaire (DHQ). Non fasting blood samples were collected from the women for measurement of homocysteine, hemoglobin, ferritin, unbound iron-binding capacity (UIBC) and total iron-binding capacity (TIBC).

Results

Energy intake increased as pregnancy advanced, but not significantly. The daily intake of folate increased from 248.5 ± 113.1 µg/d in the first trimester to 275.4 ± 100.2 µg/d in the third trimester (P = 0.04). This was well below the recommended level of 440 µg/d and only 10% of mothers were above the levels. In the third trimester, plasma homocysteine concentration was significantly higher in the low folate group of less than 250 µg/d (P = 0.02), but not the first and second trimesters. Dietary folate intake and plasma homocysteine concentrations were not likely to be predictors of birth weight in our subjects.

Conclusions

Our study shows that Japanese women’s energy and folate intakes do not meet their energy needs during pregnancy and are at an extremely low recommended dietary allowance level throughout pregnancy.

Keywords

dietary folate intake pregnancy maternal nutrition birth weight 

References

  1. 1.
    Botto LD, Moore CA, Khoury MJ, et al (1999) Neural-tube defects. N Engl J Med 341:1509–1519CrossRefGoogle Scholar
  2. 2.
    George L, Mills JL, Johansson ALV, et al (2002) Plasma folate levels and risk of spontaneous abortion. JAMA 288:1867–1873CrossRefGoogle Scholar
  3. 3.
    Goldenberg RL, Tamura R, Cliver SP, et al (1992) Serum folate and fetal growth retardation: a matter of compliance? Obstet Gynecol 79:719–722Google Scholar
  4. 4.
    Jaccques PF, Sulsky SI, Sadowski JA, et al (1993) Comparison of micronutrient intake measured by a dietary questionnaire and biochemical indicators of micronutrient status. Am J Clin Nutr 57:182–189Google Scholar
  5. 5.
    Japan Society for the Study of Obesity (2000) Novel criteria for “obesity disease” in Japan on the recommendation of Japan Society for the Study of Obesity. J Jpn Soc Stud Obes 6:18–28Google Scholar
  6. 6.
    Kondo A, Kamihira O, Gotoh M, et al (2007) Folic acid prevents neural tube defects: international comparison of awareness among obstetricians/gynecologists and urologists. J Obstet Gynecol R 33:63–67CrossRefGoogle Scholar
  7. 7.
    Kondo A, Kamihira O, Shimosuka Y, et al (2005) Awareness of the role of folic acid, dietary folate intake and plasma folate concentration in Japan. J Obstet Gynecol Res 31:172–177CrossRefGoogle Scholar
  8. 8.
    Kondo A, Kimura K, Isobe Y, et al (2003) Folic acid reduces risks of having fetus affected with neural tube defects: dietary food folate and plasma folate concentration. Nippon Hinyokika Gakkai Zasshi 94:551–559. (in Japanese)Google Scholar
  9. 9.
    Lindblad B, Zaman S, Malik A, et al (2005) Folate, vitamin B12 and homocysteine levels in South Asian women with growthretarded fetuses. Acta Obstet Gynecol Scand 84:1055–1061CrossRefGoogle Scholar
  10. 10.
    Matsuyama N, Yamaguchi M, Toyosato M, Takayama M, Mizuno K (2001), New enzymatic colorimetric assay for total homocysteine. Clin Chem 47:2155–2157Google Scholar
  11. 11.
    McPartlin J, Halligan A, Scott JM, Darling M, Weir DG (1993) Accelerated folate breakdown in pregnancy. Lancet 431:148–149CrossRefGoogle Scholar
  12. 12.
    Ministry of Health, labour, Welfare, Japan, Mothers’ and Children’s Health Division (2004) Maternal and child health statistics of Japan. Mothers’ and Children’s Health Organization, TokyoGoogle Scholar
  13. 13.
    Mito N, Takimoto H, Umegaki K, et al (2007) Folate intakes and folate biomarker profiles of pregnant Japanese women in the first trimester. Eur J Clin Nutr 61:83–90CrossRefGoogle Scholar
  14. 14.
    Nelen WL, Blom HJ, Steegers EA, et al (2000) Homocysteine and folate levels as risk factors for recurrent early pregnancy loss. Obstet Gynecol 95:519–524CrossRefGoogle Scholar
  15. 15.
    Persad VL, Van den Hof MC, Dube JM, Zimmer P (2002) Incidence of open neural tube defecs in Nova Scotia after folic acid fortification. CMAJ 167:241–245Google Scholar
  16. 16.
    Refsum H (2001) Folate, vitamin B12 and homocysteine in relation to birth defects and pregnancy outcome. Br J Nutr 85(Suppl):S109–S113CrossRefGoogle Scholar
  17. 17.
    Relton CL, Pearce MS, Burn J, Parker L (2005) An investigation of folate-related genetic factors in the determination of birthweight. Paediatr Perinat Epidemiol 19:360–367CrossRefGoogle Scholar
  18. 18.
    Relton CL, Pearce MS, Parker L (2005) The influence of erythrocyte folate and serum vitamin B12 status on birthweight. Br J Nutr 93:593–599CrossRefGoogle Scholar
  19. 19.
    Research Group for Health, Nutrition Information (2004) The national nutrition survey in Japan, ministry of health, labour and welfare, Japan: results of 2002 survey. Daiichi Shuppan Publishing, Tokyo. (in Japanese)Google Scholar
  20. 20.
    Sasaki S, Yanagibori R, Amano K (1998) Self-administered diet history questionnaire developed for health education: a relative validation of the test-version by comparison with 3-day diet record in women. J Epidemiol 8:203–215Google Scholar
  21. 21.
    Scholl TO, Hediger ML, Schall JI, Khoo CS, Fisher RL (1996) Dietary and serum folate: their influence on the outcome pregnancy. Am J Clin Nutr 63:520–525Google Scholar
  22. 22.
    Science, Technology Agency, Japan (2000) Standard tables of food composition in Japan, 5th edn. Printing Bureau of the Ministry of Finance, Tokyo, (in Japanese)Google Scholar
  23. 23.
    Stevenson RE, Allen WP, Pai GS, et al (2000) Decline in prevalence of open neural tube defects in a high-risk region of the United State. Pediatrics 106:677–683CrossRefGoogle Scholar
  24. 24.
    Sumiyoshi Y (2004) A study on monitoring of congenital anomalies. The Ministry or Health, Labour, Welfare, Tokyo, (in Japanese)Google Scholar
  25. 25.
    Takimoto H, Mito N, Umegaki K, et al (2007) Relationship between dietary folate intakes, maternal plasma total homocysteine and B-vitamins during pregnancy and fetal growth in Japan. Eur J Nutr 46:300–306CrossRefGoogle Scholar
  26. 26.
    Ueda Y, Maruo M, Ashitaka Y, Honda Y, Miyama T (2004) Studies on the validity of the present criteria for optimal maternal weight gain during pregnancy: reevaluation of the changes in maternal and neonatal weight occurring during the period of 15 years beginning from 1988. Adv Obstet Gynecol 57:121–130, (in Japanese)Google Scholar
  27. 27.
    US Food, Drug Administration (1996) Food standards: amendment of standards of identity for enriched grain products to require addition of folic acid. Fed Regist 61:878–897Google Scholar
  28. 28.
    Yajnik CS, Deshpande SS, Panchanadikar AV, et al (2005) Maternal total homocysteine concentration and neonatal size in India. Asia Pac J Clin Nutr 14:179–181Google Scholar

Copyright information

© Spinger 2008

Authors and Affiliations

  • Hiroko Watanabe
    • 1
  • Hideoki Fukuoka
    • 2
  • Takashi Sugiyama
    • 3
  • Yasushi Nagai
    • 4
  • Kayoko Ogasawara
    • 4
  • Nobuo Yoshiike
    • 5
  1. 1.Human Health Science, Graduate school of MedicineKyoto UniversityKyotoJapan
  2. 2.Comprehensive Research OrganizationWaseda UniversityTokyoJapan
  3. 3.Department of Obstetrics and GynecologyMie University Graduate School of MedicineMieJapan
  4. 4.Nagai ClinicSaitamaJapan
  5. 5.National Institute of Health and NutritionTokyoJapan

Personalised recommendations