Is Folic Acid Supplementation Really Necessary in Preterm Infants ≤32 Weeks of Gestation?

Öncel, Mehmet Yekta; Çalışıcı, Erhan; Оздемир, Рамазан; Yurttutan, Sadık; Erdeve, Ömer; Karahan, Sevilay; Dilmen, Uğur

doi:10.1097/mpg.0000000000000181

Cited by 12 publications

(18 citation statements)

References 19 publications

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“…FA is essential for humans and acts as a cofactor in certain biological reactions [122]; it is needed in the biosynthesis of purines and pyrimidines, for mitotic cell division, in the metabolism of some amino acids and for hystidine catabolism [49,123]. FA is involved in the modulation of one-carbon metabolism; it provides methyl donors for biosynthetic methylation of DNA and histones, influencing gene expression, neurotransmitter synthesis and restoration of DNA; it is especially important in aiding rapid cell division and growth, becoming essential for foetal development and growth [118,124].…”

Section: Folic Acidmentioning

confidence: 99%

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ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Vitamins

Braegger

Bronský

Cai³

et al. 2018

Clinical Nutrition

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Section: Folic Acidmentioning

confidence: 99%

“…potentially leading to deficiency. The most important factors influencing serum FA levels during the first month of life are maternal supplementation during gestation [125] and mother smoking [123].…”

Section: Folic Acidmentioning

confidence: 99%

ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Vitamins

Braegger

Bronský

Cai³

et al. 2018

Clinical Nutrition

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“…The basal RBCFL and serum folate levels were not low in any babies. In a study conducted in Turkey, the mean serum folate level was reported as 11.5-71.7 ng/mL in 162 babies with a gestational age of ≤ 32 weeks (14). The serum folate and RBCFL levels in the study…”

Section: Discussionmentioning

confidence: 99%

“…In two studies in which babies fed with preterm formula or FBM were evaluated in terms of FA supplementation, it was reported that these babies did not require FA supplementation (14,20).…”

mentioning

confidence: 99%

Assessment of different folic acid supplementation doses for low-birth-weight infants

et al. 2016

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Aim: The adequacy of 50 mcg folic acid supplementation given to low-birth-weight babies was investigated. The folate levels of the mothers and infants, and breastmilk, and the optimum dose for folic acid supplementation were also investigated. Material and Methods:After obtaining blood from 141 low-birth-weight infants on the 1st day of life for serum and red cell folate levels, the infants were randomly allocated into three groups according to the folic acid supplement dose. Forty-six infants were given 25 µg/d folic acid, 39 were given 50 µg/d folic acid, and 44 were given 75 µg/d folic acid. Folic acid could not be given to 12 infants. Follow-up blood samples were obtained at the end of folic acid supplementation. Maternal samples for red cell and serum folate levels and breast milk folate levels were obtained within the first 48 hours and the samples for measuring breastmilk folate level were obtained on the 3rd day postnatally. The feeding modes of the infants, maternal folic acid intake, and details of neonate intensive care unit course were recorded. Results:The mean birth weight and gestational age of the infants were found as 1788.2±478.4 g and 33.5±2.9 weeks, respectively. The mean serum and red cell folate levels on admission were found as 21.2±12.2 ng/mL and 922.7±460.7 ng/mL, respectively. The mean maternal serum and red cell folate levels and the mean breast milk folate levels were found as 12.3±7.5 ng/mL, 845.5±301.4 ng/mL, and 30.6±33.0 ng/m, respectively. The breast milk folate levels of mothers who were supplemented with folic acid during pregnancy were significantly higher compared with mothers who were not supplemented with folic acid (p<0.001). Infants who were supplemented with folic acid had higher follow-up serum folate levels compared with the basal level in all groups, but there was no statistically significant difference between the groups. Conclusion:This study showed that the folic acid doses of 25, 50, and 75 µcg/d affected serum folate levels similarly. We can conclude that the dose of 25 µcg/d is adequate for low-birth-weight infants. (Turk Pediatri Ars 2016; 51: 210-6)

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“…Preterm infants receiving parenteral nutrition with high folic acid content have no risk of folate deficiency during the first 2 months of age, but infants fed orally could be at risk for folate deficiency. Micronutrient support of maternal milk and the development of modern preterm formulas for preterm infants have decreased the need for folic acid supplementation, although the practice of folic acid supplementation remains commonplace, in the absence of a systematic review to support folate supplementation in preventing anaemia of prematurity (70) .…”

Section: Folic Acidmentioning

confidence: 99%

Appropriate and inappropriate vitamin supplementation in children

et al. 2020

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The vitamin status of a child depends on many factors and most of the clinical studies do not take into account the different access to adequate nutrition of children coming from different countries and the consequent major differences in micronutrients or vitamin deficits between low-income and high-income countries. Vitamin supplements are included in the general field of dietary supplements. There is a large amount of not always factual material concerning vitamin supplements, and this may sometimes create confusion in clinicians and patients. Inadequate information may lead to the risk of attributing beneficial properties leading to their over-use or misuse in the paediatric field. Vitamin supplementation is indicated in all those conditions in which a vitamin deficiency is found, either because of a reduced intake due to reduced availability of certain foods, restrictive diets or inadequate absorption. The lack of guidelines in these fields may lead paediatricians to an improper use of vitamins, both in terms of excessive use or inadequate use. This is due to the fact that vitamin supplementation is often intended as a therapy of support rather than an essential therapeutic tool able to modify disease prognosis. In fact, various vitamins and their derivatives have therapeutic potential in the prevention and treatment of many diseases, especially in emerging conditions of paediatric age such as type 2 diabetes and the metabolic syndrome. The aim of the present article is to analyse the state of the art and consider new perspectives on the role of vitamin supplements in children.

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Is Folic Acid Supplementation Really Necessary in Preterm Infants ≤32 Weeks of Gestation?

Cited by 12 publications

References 19 publications

ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Vitamins

ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Vitamins

Assessment of different folic acid supplementation doses for low-birth-weight infants

Appropriate and inappropriate vitamin supplementation in children

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