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Published on: August 7, 2017
Association of prenatal folate status with early childhood wheeze and atopic dermatitis
A Roy1,2,3, M Kocak4, T J Hartman5
1Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
Insights
High prenatal folic acid levels in mid-pregnancy were linked to fewer cases of childhood wheezing. This study suggests high folate exposure during pregnancy does not increase the risk of childhood atopic diseases.
Area of Science:
- Maternal and Child Health
- Nutritional Epidemiology
- Environmental Health
Background:
- Folic acid supplementation is crucial for preventing prenatal birth defects.
- Fortification of foods with folic acid is common in the USA.
- High prenatal folate exposure is being investigated for potential risks in childhood atopic diseases.
Purpose of the Study:
- To investigate the association between prenatal folate levels and early childhood wheeze and atopic dermatitis.
- To examine if high folate exposure during pregnancy impacts the development of childhood allergic conditions.
Main Methods:
- Study included 858 mother-child dyads enrolled prenatally.
- Maternal plasma folate levels were measured in the second and third trimesters.
- Childhood wheeze and atopic dermatitis were assessed at age 3 using parental reports and diagnoses.
Main Results:
- Median maternal folate levels were above 20 ng/mL in both trimesters.
- Higher second-trimester folate (≥20 ng/mL) was associated with reduced odds of current wheeze at age 3 (aOR=0.67).
- Third-trimester folate levels showed no significant association with childhood wheeze or atopic dermatitis.
Conclusions:
- Elevated plasma folate in mid-pregnancy correlated with a decreased likelihood of childhood wheeze.
- Findings suggest that high prenatal folate levels may not pose a risk for childhood atopic diseases in this US cohort.
Background:
Prenatal folic acid supplementation is recommended to prevent birth defects. Some foods are fortified in the USA to ensure sufficient intake among reproductive-aged women. However, high prenatal folate exposure may be a risk factor for childhood atopic diseases. We investigated associations between prenatal folate and early childhood wheeze and atopic dermatitis in a US cohort.
Methods:
We studied 858 mother-child dyads, enrolled prenatally. Folate was measured in 2nd and 3rd trimester maternal plasma. Parents reported current wheeze (previous 12 months) and healthcare provider diagnosis of atopic dermatitis at 3 years. We examined associations using logistic regression, modeling folate continuously and dichotomously (< or ≥20 ng/mL), a level often considered supraphysiologic.
Results:
Over half of women were African American and on Medicaid. Median (interquartile range) folate levels were 22.6 (15.9-30.0) and 23.1 (16.1-30.0) ng/mL for 2nd and 3rd trimesters, respectively. Current wheeze and atopic dermatitis were reported for 20.4% and 26.8% of children, respectively. Second trimester folate as a continuous exposure was not significantly associated with outcomes. Decreased odds of current wheeze were observed in children born to mothers who had 2nd trimester folate ≥20 ng/mL (adjusted odds ratios = 0.67, 95% confidence interval = 0.46, 0.97) compared to children with maternal levels <20 ng/mL. Third trimester folate was not associated with outcomes.
Conclusions:
High plasma folate in mid-pregnancy was associated with decreased odds of current wheeze at age 3. Our findings do not support harmful effects of high prenatal folate levels on childhood atopic diseases in this setting.
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