학술논문

Maternal folate, one‐carbon metabolism and pregnancy outcomes.
Document Type
Article
Source
Maternal & Child Nutrition. Jan2021, Vol. 17 Issue 1, p1-17. 17p.
Subject
*THERAPEUTIC use of folic acid
*RISK factors of preeclampsia
*CARBON metabolism
*BIRTH size
*BIRTH weight
*CONFIDENCE intervals
*GESTATIONAL diabetes
*DIET
*DIETARY supplements
*FATHERS
*FOLIC acid
*FOOD habits
*HYPERTENSION in pregnancy
*PREMATURE infants
*INGESTION
*INTERVIEWING
*PREGNANCY complications
*PREGNANT women
*RESEARCH funding
*RISK assessment
*VITAMIN B12
*HOMOCYSTEINE
*MULTIPLE regression analysis
*SECONDARY analysis
*DATA analysis software
*SINGLE nucleotide polymorphisms
*DESCRIPTIVE statistics
*ODDS ratio
*GENOTYPES
*PREGNANCY outcomes
*DISEASE risk factors
*PREGNANCY
Language
ISSN
1740-8695
Abstract
Single nucleotide polymorphisms and pre‐ and peri‐conception folic acid (FA) supplementation and dietary data were used to identify one‐carbon metabolic factors associated with pregnancy outcomes in 3196 nulliparous women. In 325 participants, we also measured circulating folate, vitamin B12 and homocysteine. Pregnancy outcomes included preeclampsia (PE), gestational hypertension (GHT), small for gestational age (SGA), spontaneous preterm birth (sPTB) and gestational diabetes mellitus (GDM). Study findings show that maternal genotype MTHFR A1298C(CC) was associated with increased risk for PE, whereas TCN2 C766G(GG) had a reduced risk for sPTB. Paternal MTHFR A1298C(CC) and MTHFD1 G1958A(AA) genotypes were associated with reduced risk for sPTB, whereas MTHFR C677T(CT) genotype had an increased risk for GHT. FA supplementation was associated with higher serum folate and vitamin B12 concentrations, reduced uterine artery resistance index and increased birth weight. Women who supplemented with <800 μg daily FA at 15‐week gestation had a higher incidence of PE (10.3%) compared with women who did not supplement (6.1%) or who supplemented with ≥800 μg (5.4%) (P <.0001). Higher serum folate levels were found in women who later developed GDM compared with women with uncomplicated pregnancies (Mean ± SD: 37.6 ± 8 nmol L−1 vs. 31.9 ± 11.2, P =.007). Fast food consumption was associated with increased risk for developing GDM, whereas low consumption of green leafy vegetables and fruit were independent risk factors for SGA and GDM and sPTB and SGA, respectively. In conclusion, maternal and paternal genotypes, together with maternal circulating folate and homocysteine concentrations, and pre‐ and early‐pregnancy dietary factors, are independent risk factors for pregnancy complications. [ABSTRACT FROM AUTHOR]