Shanghai Preconception Cohort (SPCC) for the association of periconceptional parental key nutritional factors with health outcomes of children with congenital heart disease: a cohort profile

Abstract

PurposeThe Shanghai Preconception Cohort (SPCC) was initially established to investigate the associations of parental periconceptional nutritional factors with congenital heart disease (CHD) but has further analysed child growth and development and paediatric diseases.ParticipantsPreparing-for-pregnancy couples who presented at Shanghai preconception examination clinics and early-pregnancy women before 14 gestational weeks were enrolled to comprise the periconceptional baseline study population. General characteristics, routine clinical data and consumption of diet supplements, such as folic acid and multivitamins, were collected. Blood samples were obtained at preconception and early, middle and late gestations using standard procedures. Multiple nutritional factors, including folate, homocysteine, vitamin A, vitamin D, vitamin E and metals, in the blood samples of participants selected using a case–control design were examined. Genomic DNA was extracted.Findings to dateThe baseline population included 8045 preconception couples, 3054 single women and 15 615 early-pregnancy women. Data from 12 402 births were collected, and follow-up of the cohort for other outcomes is ongoing. Currently, 151 cases of CHD were identified after birth. The pilot analysis in a small subgroup showed that approximately 20.0% of preconception women and 44.9% of early-pregnancy women had red blood cell (RBC) folate levels that met the international recommendation for preventing neural tube defects.Future plansOnce a sufficient number of CHD cases are achieved, we will investigate the quantitative association of preconception RBC folate levels with CHD using a nested case–control design. The SPCC will be followed up for 18 years to investigate extensive outcomes of growth, development, obesity, and common and rare diseases during childhood and adolescence according to our plan. Blood nutritional factors will be examined in participants selected for specific aims. The SPCC will also allow for prospective cohort studies on extensive research questions.Trial registration numberNCT 02737644

Association of Maternal Folate and Vitamin B12 in Early Pregnancy With Gestational Diabetes Mellitus: A Prospective Cohort Study

“…This study was conducted within the Shanghai Preconception Cohort (SPCC; NCT02737644) that aims to investigate the associations between periconceptional maternal key nutrients and neonatal health outcomes, including congenital heart disease ( 20 ). Two subcohorts consisting of 938 and 458 subjects were derived for studying the associations of RBC folate with congenital heart diseases and infant atopic dermatitis.…”

“…The details of blood sample collection and nutritious biomarker measurements were described elsewhere ( 20 ). Briefly, the remaining blood samples after routine examinations at the first antenatal visit were collected by trained staff.…”

Maternal liver dysfunction in early pregnancy predisposes to gestational diabetes mellitus independent of preconception overweight: A prospective cohort study

“…This prospective cohort was derived from the ongoing Shanghai Preconception Cohort Study (SPCC: NCT02737644) that aims to investigate the associations of parental periconceptional nutrition factors with congenital heart disease, childhood growth and development, as well as subsequent paediatric diseases. 11 In this study, pregnant women recruited from prenatal care hospitals who had LFB measurements in early pregnancy (between 9 and 13 weeks of gestation) and an oral glucose tolerance test (OGTT) at completion of pregnancy with three glucose measurements for GDM diagnosis between 24 and 28 weeks of gestation were eligible for this study. Those with a history of type 2 diabetes or taking hypoglycemic agents or with diagnosed liver disease were excluded.…”

“…9,10 It is still unclear whether obesity could modify the association between GGT and GDM. With the advantage of our larger prospective cohort, 11 we aim to elucidate whether the associations of maternal LFBs with GDM are independent of overweight.…”

New supplementation proposals for pregnant women with foetal cardiac diseases

“…Heart defects are among the most common congenital defects in humans, and low concentrations of folic acid, hyperhomocysteinaemia, and MTHFR polymorphisms are also very common in children with congenital heart defects and their mothers. The relationship between mutations of the MTHFR gene and the occurrence of congenital heart defects in children has also been proven [3,4]. Should we also consider increasing the standard dose of 400 µg of folic acid for patients who have given birth to a child with a congenital heart defect, analogous to the recommendations prepared for families with a positive history of NTD (Table I) [1]?…”