Population red blood cell folate concentrations for prevention of neural tube defects: bayesian model

Crider, Krista S.; Devine, Owen; Lü, Hao; Dowling, Nicole F.; Li, Song; Molloy, Anne M.; Li, Zhu; Zhu, Jianghui; Berry, R. J.

doi:10.1136/bmj.g4554

Cited by 177 publications

(230 citation statements)

References 45 publications

Supporting

Mentioning

219

Contrasting

Unclassified

Order By: Relevance

“…Dotted lines represent the 95% credible interval. The shaded area (natural food intakes between 450 μg DFE/day and 650 g DFE/day) refer to the range of intakes and RBC folate concentrations associated with the lowest population risk for a NTD according to Crider et al (2014). Based on data from Marchetta et al (2015).…”

Section: Response Of Folate Status To Folate Intake and Supplementationmentioning

confidence: 99%

Genetic polymorphisms and folate status

Hiraoka

Kagawa

2017

Congenital Anomalies

136

102

View full text Add to dashboard Cite

Moderate hyperhomocysteinemia‐induced low folate status is an independent risk factor for cardiovascular disease, dementia, and depression. Folate is an essential cofactor in the one‐carbon metabolism pathway and is necessary in amino acid metabolism, purine and thymidylate synthesis, and DNA methylation. In the folate cycle and homocysteine metabolism, folate, vitamin B12, vitamin B6, and vitamin B2 are important cofactors. Many enzymes are involved in folate transport and uptake, the folate pathway, and homocysteine (Hcy) metabolism, and various polymorphisms have been documented in these enzymes. Serum folate and total Hcy (tHcy) levels are influenced by folate intake and genetic polymorphisms in 5,10‐methylenetertahydrofolate reductase (MTHFR) such as C677T. The prevalence of the MTHFR 677TT genotype varies across ethnic groups and regions, with a frequency of approximately 15% in Japanese populations. Individuals with the TT genotype have significantly higher tHcy levels and lower folate levels in serum than those with the CT and TT genotypes. However, administration of folic acid has been shown to eliminate these differences. Moreover, data have suggested that interventions based on genotype may be effective for motivating individuals to change their lifestyle and improve their nutrition status. Accordingly, in this review, we discuss the effects of MTHFR C677T polymorphisms on serum tHcy and folate levels with folic acid intervention and evaluate approaches for overcoming folic acid deficiency and related symptoms.

show abstract

Section: Response Of Folate Status To Folate Intake and Supplementationmentioning

confidence: 99%

Genetic polymorphisms and folate status

Hiraoka

Kagawa

2017

Congenital Anomalies

136

102

View full text Add to dashboard Cite

show abstract

“…European guidelines regarding FA supplementation do not currently feature an explicit recommendation concerning the required duration of FA supplementation preconceptionally. This suggests that there is a need to update our national and European FA guidelines to include a recommendation on the ideal timing of FA preconceptionally, in view of the recent kinetic studies in this area (7)(8)(9)(10) . This message should be incorporated into renewed public health campaigns in this area to enhance the clinical effectiveness of periconceptional FA supplementation.…”

Section: Public Health Nutritionmentioning

confidence: 99%

“…Given the limited Irish data describing the duration of periconceptional FA supplementation and the rising incidence of NTD in Ireland, examination of the duration of periconceptional FA supplementation is important. Kinetic studies have shown that those who consumed 400 µg FA/d reached an RBC folate concentration associated with optimally reduced risk of NTD after 3 to 6 months (7)(8)(9) . Therefore, it is important to establish whether or not women who take FA preconceptionally are doing so for the required duration to optimise NTD prevention.…”

mentioning

confidence: 99%

“…National and international guidelines recommend that all women planning a pregnancy should take 400 µg FA each day as an oral supplement, starting periconceptionally prior to the closure of the neural tube which occurs at 3-4 weeks after conception (3)(4)(5) . Scientific evidence suggests that the risk of NTD is substantially attenuated at red-blood-cell (RBC) folate concentrations of 906-1000 nmol/l (6,7) . In recent kinetic studies, it has been shown that it takes 12 weeks of daily supplementation with 400 µg FA to achieve these levels of RBC folate at which NTD prevention is optimised (8)(9)(10) .…”

mentioning

confidence: 99%

See 1 more Smart Citation

Duration of periconceptional folic acid supplementation in women booking for antenatal care

Cawley¹,

Mullaney²,

Kennedy³

et al. 2016

Public Health Nutr.

View full text Add to dashboard Cite

ObjectiveTo provide accurate estimates of the commencement time, duration and dosage of folic acid (FA) supplementation taken by Irish women in the periconceptional period. The study also aimed to establish the factors associated with optimal FA supplementation practices.DesignCross-sectional observational study. Women’s clinical and sociodemographic details were computerised. Maternal weight and height were measured before calculating BMI. Detailed FA supplementation questionnaires were completed under the supervision of a trained researcher.SettingA large university maternity hospital, Republic of Ireland, January 2014–April 2016.SubjectsWomen (n856) recruited at their convenience in the first trimester.ResultsWhile almost all of the women (97 %) were taking FA at enrolment, only one in four women took FA for at least 12 weeks preconceptionally (n208). Among the 44 % of women who were supplementing with FA preconceptionally, 44 % (162/370) reported taking FA for less than the 12 weeks required to achieve optimal red-blood-cell folate levels for prevention of neural tube defects. On multivariate analysis, only planned pregnancy and nulliparity were associated with taking FA for at least 12 weeks preconceptionally. Among women who only took FA postconceptionally, almost two-thirds commenced it after day 28 of their pregnancy when the neural tube had already closed.ConclusionsAs the timing of FA was suboptimal both before and after conception, we recommend that current national FA guidelines need to be reviewed.

show abstract

“…In recent kinetic studies, it has been shown that it takes 12 weeks of daily supplementation with 400μg FA to achieve the level of red cell folate (RCF) associated with reduced risk of neural tube defects (NTDs) (3) . The aim of this cross-sectional observational study was to analyse in detail the use of FA supplementation including timing of commencement and duration of usage; in women presenting for antenatal care in the first trimester of pregnancy.…”

mentioning

confidence: 99%

Duration of periconceptional folic acid supplementation in women booking for antenatal care

Cawley¹,

Mullaney²,

Kennedy³

et al. 2016

Proc. Nutr. Soc.

View full text Add to dashboard Cite

National and international guidelines recommend that all women planning a pregnancy should take a 400μg supplement of folic acid (FA) each day, starting periconceptionally prior to the closure of the neural tube (1,2) . In recent kinetic studies, it has been shown that it takes 12 weeks of daily supplementation with 400μg FA to achieve the level of red cell folate (RCF) associated with reduced risk of neural tube defects (NTDs) (3) . The aim of this cross-sectional observational study was to analyse in detail the use of FA supplementation including timing of commencement and duration of usage; in women presenting for antenatal care in the first trimester of pregnancy.Women were recruited at their convenience in the first trimester, and their clinical and sociodemographic details computerised. Maternal weight and height were measured and body mass index (BMI) calculated. Detailed FA supplementation questionnaires were completed under the supervision of a trained researcher. This study population was representative of the national obstetric population (4) .While almost all of the 856 women (96·7 %) were taking FA at enrolment; only one in four women took FA for at least 12 weeks preconceptionally (n = 208, 24·5 %). Amongst the women who supplemented with FA preconceptionally, 43·8 % (162/370) reported taking FA for less than the required 12 weeks to achieve optimal red cell folate (RCF) levels for NTD prevention. Amongst women who only took FA post-conceptionally, almost two-thirds (61 %) commenced it after day 28 of their pregnancy when the neural tube had already closed.As the timing and duration of FA supplementation is suboptimal both before and after conception, we recommend that current national FA guidelines need to be reviewed and revised to address these important issues.

show abstract

Population red blood cell folate concentrations for prevention of neural tube defects: bayesian model

Cited by 177 publications

References 45 publications

Genetic polymorphisms and folate status

Genetic polymorphisms and folate status

Duration of periconceptional folic acid supplementation in women booking for antenatal care

Duration of periconceptional folic acid supplementation in women booking for antenatal care

Contact Info

Product

Resources

About