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Updated: May 23, 2025
Author Spotlight: Studying the Impact of Maternal Dietary Deficiencies on Long-Term Offspring Health Outcomes
Published on: June 28, 2024
Maternal serum folate status during early pregnancy: Sex-specific association with neonatal adiposity
Nishanthi Periyathambi1, Nithya Sukumar1, Yonas Ghebremichael-Weldeselassie2
1Warwick Applied Health, Warwick Medical School, University of Warwick, Gibbet Hill, Warwick, Coventry, UK; Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital, Nuneaton, UK.
Insights
High early pregnancy folate levels are linked to increased adiposity in male newborns, but not females. Maternal glucose levels did not mediate this association, suggesting a sex-specific effect of folate on infant development.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Health
- Nutritional Science
Background:
- Maternal folate intake during early pregnancy is crucial for fetal development.
- Previous studies suggest links between folate, gestational diabetes, and neonatal adiposity.
Purpose of the Study:
- To investigate the association between maternal early pregnancy folate levels and sex-specific neonatal anthropometry.
- To explore whether maternal glycemia mediates the relationship between folate and neonatal adiposity.
Main Methods:
- Analysis of data from 511 participants in a UK multi-ethnic early pregnancy longitudinal study (PRiDE).
- Measurement of maternal serum folate in early pregnancy and infant anthropometry (skinfold thickness, mid-upper arm circumference) at birth.
- Use of multiple linear regression and interaction analysis to assess relationships and mediation by maternal glucose.
Main Results:
- Excess folate levels (≥45 nmol/l) were observed in 40.3% of pregnant women.
- Higher early pregnancy folate was positively associated with male newborn triceps skinfold thickness (std β = 0.17, p < 0.05) after confounder adjustment.
- No significant associations were found in female newborns, and maternal glucose levels (fasting and 2-h plasma glucose) did not mediate the folate-adiposity link.
Conclusions:
- Maternal folate levels in early pregnancy may have a sex-specific influence on infant anthropometric indices.
- The observed association between folate and newborn adiposity is not mediated by maternal glucose levels during mid-pregnancy.
Background & Aims:
Early pregnancy folate has been associated with GDM and possible adiposity in the newborn. The present study examined associations between maternal early pregnancy folate levels and sex-specific neonatal anthropometry. We further explored possible mediation by maternal glycemia on the association between folate and neonatal adiposity.
Methods:
Sub-group data (n = 511) from a UK multi-ethnic early pregnancy longitudinal study (micronutrients in Pregnancy as a Risk factor for gestational Diabetes and Effects on mother and baby; PRiDE) was used. Maternal serum folate was assessed during early pregnancy (Mean ± SD = 12.5 ± 1.6 gestational weeks) and infant anthropometry including skinfold thickness (SFT) and mid-upper arm circumference (MUAC) at birth. Multiple linear regression was performed to analyse the relationship between maternal folate and infant adiposity indices. Interaction analysis was used to identify maternal glucose mediation of this relationship.
Results:
Excess folate levels (≥45 nmol/l) were found in 40.3 % pregnant women (n = 206). Early pregnancy folate (1 SD unit) was positively associated with male newborn triceps SFT (std β = 0.17 (95 % CI: 0.06, 0.29; p < 0.05)) after adjusting for key maternal and infant confounders in multiple comparisons using Benjamini-Hochberg procedure. However, no associations were seen in female newborns. No influence of maternal fasting (FPG) and 2-h plasma glucose (2 h-PG) were detected on the association between folate and newborn anthropometry.
Conclusion:
Our findings suggest a potential sex-specific influence of maternal folate on infant anthropometric indices. The association between early pregnancy folate on newborn adiposity was not mediated by maternal FPG and/or 2 h-PG at 24-28 weeks.
