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Folic acid supplementation, dietary folate intake and risk of small for gestational age in China

Published online by Cambridge University Press:  02 December 2019

Huaqi Guo
Affiliation:
Neonatology Department, Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou730050, Gansu Province, People’s Republic of China School of Public Health, Shanghai Jiao Tong University, Shanghai, People’s Republic of China School of Public Health, Lanzhou University, No. 199 Dong Gang West Road, Lanzhou730000, Gansu Province, People’s Republic of China
Baohong Mao
Affiliation:
Neonatology Department, Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou730050, Gansu Province, People’s Republic of China
Meng Wang
Affiliation:
Neonatology Department, Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou730050, Gansu Province, People’s Republic of China School of Public Health, Lanzhou University, No. 199 Dong Gang West Road, Lanzhou730000, Gansu Province, People’s Republic of China
Qing Liu
Affiliation:
Neonatology Department, Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou730050, Gansu Province, People’s Republic of China
Liping Yang
Affiliation:
Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu Province, People’s Republic of China
Yahui Xie
Affiliation:
Neonatology Department, Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou730050, Gansu Province, People’s Republic of China
Yanxia Wang
Affiliation:
Neonatology Department, Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou730050, Gansu Province, People’s Republic of China
Xiaochun He
Affiliation:
Neonatology Department, Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou730050, Gansu Province, People’s Republic of China
Hongmei Cui
Affiliation:
Neonatology Department, Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou730050, Gansu Province, People’s Republic of China
Xiaojuan Lin
Affiliation:
Neonatology Department, Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou730050, Gansu Province, People’s Republic of China
Ling Lv
Affiliation:
Neonatology Department, Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou730050, Gansu Province, People’s Republic of China
Min Zhou
Affiliation:
Neonatology Department, Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou730050, Gansu Province, People’s Republic of China
Xiaoying Xu
Affiliation:
Neonatology Department, Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou730050, Gansu Province, People’s Republic of China
Jie Qiu
Affiliation:
Neonatology Department, Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou730050, Gansu Province, People’s Republic of China School of Public Health, Lanzhou University, No. 199 Dong Gang West Road, Lanzhou730000, Gansu Province, People’s Republic of China
Yawei Zhang
Affiliation:
Yale School of Public Health, 60 College Street, New Haven, CT06520, USA
Corresponding

Abstract

Objective:

To investigate the hypothesis that folic acid supplementation and dietary folate intake before conception and during pregnancy reduce the risk of small for gestational age (SGA) and to examine the joint effect of folic acid supplementation and dietary folate intake on the risk of SGA.

Design:

Participants were interviewed by trained study interviewers using a standardized and structured questionnaire. Information on birth outcomes and maternal complications was abstracted from medical records and dietary information was collected via a semi-quantitative FFQ before conception and during pregnancy.

Setting:

A birth cohort data analysis using the 2010–2012 Gansu Provincial Maternity and Child Care Hospital.

Participants:

Women (n 8758) and their children enrolled in the study.

Results:

Folic acid supplementation was associated with a reduced risk of SGA (OR = 0·72, 95 % CI 0·60, 0·86), with the reduced risk seen mainly for SGA at ≥37 weeks of gestational age (OR = 0·70, 95 % CI 0·58, 0·85) and nulliparous SGA (OR = 0·67, 95 % CI 0·54, 0·84). There was no significant association between dietary folate intake and SGA risk.

Conclusions:

Our study suggested that folic acid supplementation was associated with a reduced risk of SGA and the risk varied by preterm status and parity.

Type
Research paper
Copyright
© The Authors 2019

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Footnotes

Huaqi Guo, Baohong Mao and Meng Wang contributed equally to the present study and should be regarded as co-first authors.

References

McIntire, DD, Bloom, SL, Casey, BMet al. (1999) Birth weight in relation to morbidity and mortality among newborn infants. N Engl J Med 340, 12341238.CrossRefGoogle ScholarPubMed
Pallotto, EK & Kilbride, HW (2006) Perinatal outcome and later implications of intrauterine growth restriction. Clin Obstet Gynecol 49, 257269.CrossRefGoogle ScholarPubMed
Hack, M, Taylor, HG, Drotar, Det al. (2005) Chronic conditions, functional limitations, and special health care needs of school-aged children born with extremely low-birth-weight in the 1990s. JAMA 294, 318325.CrossRefGoogle ScholarPubMed
Hille, ET, den Ouden, AL, Saigal, Set al. (2001) Behavioural problems in children who weigh 1000 g or less at birth in four countries. Lancet 357, 16411643.CrossRefGoogle ScholarPubMed
Nafee, TM, Farrell, WE, Carroll, WDet al. (2008) Epigenetic control of fetal gene expression. BJOG 115, 158168.CrossRefGoogle ScholarPubMed
Schlotz, W & Phillips, DI (2009) Fetal origins of mental health: evidence and mechanisms. Brain Behav Immun 23, 905916.CrossRefGoogle ScholarPubMed
Tosh, DN, Fu, Q, Callaway, CWet al. (2010) Epigenetics of programmed obesity: alteration in IUGR rat hepatic IGF1 mRNA expression and histone structure in rapid vs. delayed postnatal catch-up growth. Am J Physiol Gastrointest Liver Physiol 299, G1023G1029.CrossRefGoogle ScholarPubMed
Waterland, RA (2009) Is epigenetics an important link between early life events and adult disease? Horm Res 71, 1316.Google ScholarPubMed
Weinstock, M (2005) The potential influence of maternal stress hormones on development and mental health of the offspring. Brain Behav Immun 19, 296308.CrossRefGoogle ScholarPubMed
Lockwood, CJ (2002) Predicting premature delivery – no easy task. N Engl J Med 346, 282284.CrossRefGoogle ScholarPubMed
Krishnaswamy, K & Madhavan Nair, K (2001) Importance of folate in human nutrition. Br J Nutr 85, Suppl. 2, S115S124.CrossRefGoogle ScholarPubMed
Baker, BC, Mackie, FL, Lean, SCet al. (2017) Placental dysfunction is associated with altered microRNA expression in pregnant women with low folate status. Mol Nutr Food Res 61, 1600646.CrossRefGoogle ScholarPubMed
Bergen, NE, Jaddoe, VW, Timmermans, Set al. (2012) Homocysteine and folate concentrations in early pregnancy and the risk of adverse pregnancy outcomes: the Generation R Study. BJOG 119, 739751.CrossRefGoogle ScholarPubMed
Bukowski, R, Malone, FD, Porter, FTet al. (2009) Preconceptional folate supplementation and the risk of spontaneous preterm birth: a cohort study. PLoS Med 6, e1000061.CrossRefGoogle ScholarPubMed
Catov, JM, Bodnar, LM, Olsen, Jet al. (2011) Periconceptional multivitamin use and risk of preterm or small-for-gestational-age births in the Danish National Birth Cohort. Am J Clin Nutr 94, 906912.CrossRefGoogle ScholarPubMed
Chen, S, Zhu, R, Zhu, Het al. (2017) The prevalence and risk factors of preterm small-for-gestational-age infants: a population-based retrospective cohort study in rural Chinese population. BMC Pregnancy Childbirth 17, 237.CrossRefGoogle ScholarPubMed
Dwarkanath, P, Barzilay, JR, Thomas, Tet al. (2013) High folate and low vitamin B-12 intakes during pregnancy are associated with small-for-gestational age infants in South Indian women: a prospective observational cohort study. Am J Clin Nutr 98, 14501458.CrossRefGoogle ScholarPubMed
Furness, DL, Yasin, N, Dekker, GAet al. (2012) Maternal red blood cell folate concentration at 10–12 weeks gestation and pregnancy outcome. J Matern Fetal Neonatal Med 25, 14231427.CrossRefGoogle ScholarPubMed
Goldenberg, RL, Tamura, T, Cliver, SPet al. (1992) Serum folate and fetal growth retardation: a matter of compliance? Obstet Gynecol 79, 719722.Google ScholarPubMed
Hodgetts, VA, Morris, RK, Francis, Aet al. (2015) Effectiveness of folic acid supplementation in pregnancy on reducing the risk of small-for-gestational age neonates: a population study, systematic review and meta-analysis. BJOG 122, 478490.CrossRefGoogle ScholarPubMed
Kim, MW, Ahn, KH, Ryu, KJet al. (2014) Preventive effects of folic acid supplementation on adverse maternal and fetal outcomes. PLoS One 9, e97273.CrossRefGoogle ScholarPubMed
Li, N, Li, Z, Ye, Ret al. (2017) Impact of periconceptional folic acid supplementation on low birth weight and small-for-gestational-age infants in China: a large prospective cohort study. J Pediatr 187, 105110.CrossRefGoogle ScholarPubMed
Navarrete-Munoz, EM, Gimenez Monzo, D, Garcia de La Hera, Met al. (2010) Folic acid intake from diet and supplements in a population of pregnant women in Valencia, Spain. Med Clin (Barc) 135, 637643.Google Scholar
Navarrete-Munoz, EM, Valera-Gran, D, Garcia-de-la-Hera, Met al. (2019) High doses of folic acid in the periconceptional period and risk of low weight for gestational age at birth in a population based cohort study. Eur J Nutr 58, 241251.CrossRefGoogle Scholar
Nilsen, RM, Vollset, SE, Monsen, ALet al. (2010) Infant birth size is not associated with maternal intake and status of folate during the second trimester in Norwegian pregnant women. J Nutr 140, 572579.CrossRefGoogle Scholar
Papadopoulou, E, Stratakis, N, Roumeliotaki, Tet al. (2013) The effect of high doses of folic acid and iron supplementation in early-to-mid pregnancy on prematurity and fetal growth retardation: the mother–child cohort study in Crete, Greece (Rhea study). Eur J Nutr 52, 327336.CrossRefGoogle Scholar
Pastor-Valero, M, Navarrete-Munoz, EM, Rebagliato, Met al. (2011) Periconceptional folic acid supplementation and anthropometric measures at birth in a cohort of pregnant women in Valencia, Spain. Br J Nutr 105, 13521360.CrossRefGoogle Scholar
Rolschau, J, Kristoffersen, K, Ulrich, Met al. (1999) The influence of folic acid supplement on the outcome of pregnancies in the county of Funen in Denmark. Part I. Eur J Obstet Gynecol Reprod Biol 87, 105110.CrossRefGoogle ScholarPubMed
Ronnenberg, AG, Goldman, MB, Chen, Det al. (2002) Preconception homocysteine and B vitamin status and birth outcomes in Chinese women. Am J Clin Nutr 76, 13851391.CrossRefGoogle Scholar
Timmermans, S, Jaddoe, VW, Hofman, Aet 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.CrossRefGoogle ScholarPubMed
Wang, S, Ge, X, Zhu, Bet al. (2016) Maternal continuing folic acid supplementation after the first trimester of pregnancy increased the risk of large-for-gestational-age birth: a population-based birth cohort study. Nutrients 8, 493.CrossRefGoogle ScholarPubMed
Yan, SQ, Xu, YQ, Su, PYet al. (2013) Relationship between folic acid supplements during peri-conceptional period and the adverse pregnancy outcomes: a cohort study. Zhonghua Liu Xing Bing Xue Za Zhi 34, 14.Google ScholarPubMed
Yang, T, Gu, Y, Wei, Xet al. (2017) Periconceptional folic acid supplementation and vitamin B12 status in a cohort of Chinese early pregnancy women with the risk of adverse pregnancy outcomes. J Clin Biochem Nutr 60, 136142.CrossRefGoogle Scholar
Zheng, JS, Guan, Y, Zhao, Yet al. (2016) Pre-conceptional intake of folic acid supplements is inversely associated with risk of preterm birth and small-for-gestational-age birth: a prospective cohort study. Br J Nutr 115, 509516.CrossRefGoogle ScholarPubMed
Policy and Research Team, Save the Children China Programme (n.d.) Laws and Policies for Maternal and Young Child Health Care in China. http://resourcecentre.savethechildren.se/sites/default/files/documents/3378.pdf (accessed November 2019).Google Scholar
Kloosterman, GJ (1970) On intrauterine growth. Int J Gynecol Obstet 8, 895912.CrossRefGoogle Scholar
Shaw, GM, Carmichael, SL, Nelson, Vet 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.CrossRefGoogle ScholarPubMed
de Bree, A, van Dusseldorp, M, Brouwer, IAet al. (1997) Folate intake in Europe: recommended, actual and desired intake. Eur J Clin Nutr 51, 643660.CrossRefGoogle ScholarPubMed
Scholl, TO & Johnson, WG (2000) Folic acid: influence on the outcome of pregnancy. Am J Clin Nutr 71, 5 Suppl., 1295S1303S.CrossRefGoogle ScholarPubMed
World Health Organization & Food and Agriculture Organization of the United Nations (2004) Folate and folic acid. In Vitamin and Mineral Requirements in Human Nutrition, 2nd ed., pp. 289302. Rome: FAO.Google Scholar
Ren, AG (2015) Prevention of neural tube defects with folic acid: the Chinese experience. World J Clin Pediatr 4, 4144.CrossRefGoogle ScholarPubMed
Liu, J, Jin, L, Meng, Qet al. (2015) Changes in folic acid supplementation behaviour among women of reproductive age after the implementation of a massive supplementation programme in China. Public Health Nutr 18, 582588.CrossRefGoogle ScholarPubMed
Zeng, Z & Zhu, J (2010) Low folic acid supplement intake rate among women in northern China with a high-prevalence of neural tube defects, 2008. Prev Med 51, 338339.CrossRefGoogle ScholarPubMed
Zhang, L, Ren, A, Li, Zet al. (2006) Folate concentrations and folic acid supplementation among women in their first trimester of pregnancy in a rural area with a high prevalence of neural tube defects in Shanxi, China. Birth Defects Res A Clin Mol Teratol 76, 461466.CrossRefGoogle Scholar
Liu, X, Lv, L, Zhang, Het al. (2016) Folic acid supplementation, dietary folate intake and risk of preterm birth in China. Eur J Nutr 55, 14111422.CrossRefGoogle ScholarPubMed
Qiu, J, He, X, Cui, Het al. (2014) Passive smoking and preterm birth in urban China. Am J Epidemiol 180, 94102.CrossRefGoogle ScholarPubMed
Wang, Y, Zhao, N, Qiu, Jet al. (2015) Folic acid supplementation and dietary folate intake, and risk of preeclampsia. Eur J Clin Nutr 69, 11451150.CrossRefGoogle ScholarPubMed
Zhao, N, Qiu, J, Zhang, Yet al. (2015) Ambient air pollutant PM10 and risk of preterm birth in Lanzhou, China. Environ Int 76, 7177.CrossRefGoogle ScholarPubMed
Dai, L, Deng, C, Li, Yet al. (2014) Birth weight reference percentiles for Chinese. PLoS One 9, e104779.CrossRefGoogle ScholarPubMed
Duryea, EL, Hawkins, JS, McIntire, DDet al. (2014) A revised birth weight reference for the United States. Obstet Gynecol 124, 1622.CrossRefGoogle ScholarPubMed
Institute of Nutrition and Food Hygiene, Chinese Academy of Preventive Medicine (1999) Table of Food Components (National Representative Values). Beijing: People’s Hygiene Press.Google Scholar
Tamura, T & Picciano, MF (2006) Folate and human reproduction. Am J Clin Nutr 83, 9931016.CrossRefGoogle ScholarPubMed
Timmermans, S, Jaddoe, VW, Silva, LMet al. (2011) Folic acid is positively associated with uteroplacental vascular resistance: the Generation R study. Nutr Metab Cardiovasc Dis 21, 5461.CrossRefGoogle ScholarPubMed
Bailey, LB & Gregory, JF (1999) Folate metabolism and requirements. J Nutr 129, 779782.CrossRefGoogle ScholarPubMed
Bleker, OP, Buimer, M, van der Post, JAet al. (2006) Ted (G.J.) Kloosterman: on intrauterine growth. The significance of prenatal care. Studies on birth weight, placental weight and placental index. Placenta 27, 10521054.CrossRefGoogle ScholarPubMed
Pennisi, E (2005) Environmental epigenomics meeting. Supplements restore gene function via methylation. Science 310, 1761.CrossRefGoogle ScholarPubMed
Waterland, RA & Jirtle, RL (2004) Early nutrition, epigenetic changes at transposons and imprinted genes, and enhanced susceptibility to adult chronic diseases. Nutrition 20, 6368.CrossRefGoogle ScholarPubMed
Steegers-Theunissen, RP & Steegers, EA (2003) Nutrient–gene interactions in early pregnancy: a vascular hypothesis. Eur J Obstet Gynecol Reprod Biol 106, 115117.CrossRefGoogle ScholarPubMed
Rolschau, J (1978) A prospective study of the placental weight and content of protein, RNA and DNA. Acta Obstet Gynecol Scand 57, 2843.CrossRefGoogle ScholarPubMed
Cikot, RJ, Steegers-Theunissen, RP, Thomas, CMet al. (2001) Longitudinal vitamin and homocysteine levels in normal pregnancy. Br J Nutr 85, 4958.CrossRefGoogle ScholarPubMed
Thaler, CJ (2014) Folate metabolism and human reproduction. Geburtshilfe Frauenheilkd 74, 845851.Google ScholarPubMed
McPartlin, J, Halligan, A, Scott, JMet al. (1993) Accelerated folate breakdown in pregnancy. Lancet 341, 148149.CrossRefGoogle ScholarPubMed
Scholl, TO, Hediger, ML, Schall, JIet al. (1996) Dietary and serum folate: their influence on the outcome of pregnancy. Am J Clin Nutr 63, 520525.CrossRefGoogle ScholarPubMed
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