Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-27T21:01:59.337Z Has data issue: false hasContentIssue false

The influence of erythrocyte folate and serum vitamin B12 status on birth weight

Published online by Cambridge University Press:  08 March 2007

Caroline L. Relton*
Affiliation:
Paediatric and Lifecourse Epidemiology Research Group, School of Clinical Medical Sciences (Child Health), Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK Genetics Unit, Westlakes Research Institute, Moor Row, Cumbria CA24 3JY, UK
Mark S. Pearce
Affiliation:
Paediatric and Lifecourse Epidemiology Research Group, School of Clinical Medical Sciences (Child Health), Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
Louise Parker
Affiliation:
Paediatric and Lifecourse Epidemiology Research Group, School of Clinical Medical Sciences (Child Health), Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
*
*Corresponding author: Dr Caroline L. Relton, fax +44 (0)191 2023060, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The extent to which maternal folate and vitamin B12 modulate infant birth weight is unclear. The present study investigated mothers in early gestation (mean 11·5 (sd 5·8) weeks) and neonates, at delivery. Erythrocyte (RBC) folate (mothers: n 683; neonates: n 614) and vitamin B12 (mothers: n 534; neonates: n 614) were measured. Data on smoking habits were available for 44 % of pregnancies (n 443). The relationship between vitamin levels and birth weight standardized for gender and gestational age was investigated, using linear regression and adjusting for possible confounding variables (maternal age, parity). Results are presented as standardized regression coefficients (b). Increasing maternal age was associated with elevated RBC folate (b 0·11 (95 % CI 0·08, 0·15), P<0·001; n 674) and smoking was associated with a decrease in maternal RBC folate (b −1·38 (95 % CI −1·92, −0·86), P=0·001; n 319). Neonatal RBC folate was predicted by maternal RBC folate (b 0·08 (95 % CI 0·04, 0·11), P=0·001; n 315) and maternal vitamin B12 (b 0·08 (95 % CI 0·01, 0·16), P=0·02; n 252). Smoking influenced maternal vitamin B12 status (b −0·88 (95 % CI −1·49, −0·27), P=0·005; n 231). Using univariate regression, smoking significantly influenced infant birth weight (b −2·15 (95 % CI −3·24, −1·04), P<0·001; n 437). However, the effect of smoking on birth weight was statistically non-significant when considered in a multivariate regression model, leaving maternal RBC folate as the only significant predictor of birth weight (b 0·25 (95 % CI 0·08, 0·42), P=0·005; n 145). These findings suggest that maternal folate status is an important determinant of infant birth weight. The combined effects of smoking and reduced RBC status on birth weight require further investigation.

Type
Research Article
Copyright
Copyright © The Nutrition Society 2005

References

Alberg, A (2002) The influence of cigarette smoking on circulating concentrations of antioxidant micronutrients. Toxicology 15, 121137.CrossRefGoogle Scholar
Bailey, LB (1995) Folate requirements and dietary recommendations. In Folate in Health and Disease, pp. 123169. [Bailey, LB, editor]. New York: Marcel Dekker.Google Scholar
Baschat, AA & Hecher, K (2004) Fetal growth restriction due to placental disease. Semin Perinatol 28, 6780.CrossRefGoogle ScholarPubMed
Bjorke, Monsen AL, Ueland, PM, Vollset, SE, Guttormsen, AB, Markestad, T, Solheim, E, Refsum, H (2001) Determinants of cobalamin status in newborns. Pediatrics 108, 624630.Google Scholar
Botto, LD, Khoury, MJ, Mulinare, J & Erickson, JD (1996) Periconceptional multivitamin use and the occurrence of conotruncal heart defects: results from a population-based, case-control study. Pediatrics 98, 911917.CrossRefGoogle ScholarPubMed
Brunaud, L, Alberto, JM, Ayav, A, Gerard, P, Namour, F, Antunes, L, Braun, M, Bronowicki, JP, Bresler, L & Gueant, JL (2003) Vitamin B 12 is a strong determinant of low methionine synthase activity and DNA hypomethylation in gastrectomized rats. Digestion 68, 133140.CrossRefGoogle Scholar
Burke, G, Robinson, K, Refsum, H, Stuart, B & Graham, I (1992) Intrauterine growth retardation, perinatal death and homocysteine levels. N Engl J Med 326, 6970.Google ScholarPubMed
Chase, DS, Tawn, EJ, Parker, L, Jonas, P, Parker, CO & Burn, J (1998) The North Cumbria Community Genetics Project. J Med Genet 35, 413416.CrossRefGoogle ScholarPubMed
Cogswell, ME, Weisberg, P & Spong, C (2003) Cigarette smoking, alcohol use and adverse pregnancy outcomes: implications for micronutrient supplementation. J Nutr 133 1722S – 1731S.CrossRefGoogle ScholarPubMed
Czeizel, AE & Dudas, I (1992) Prevention of the first occurrence of neural tube defect by periconceptional vitamin supplementation. N Engl J Med 327, 18321835.CrossRefGoogle ScholarPubMed
de Weerd, S, Steegers-Theunissen, RPM, de Boo, TM, Thomas, CMG & Steegers, EAP (2003) Maternal and periconceptional biochemical and hematological parameters, vitamin profiles and pregnancy outcome. Eur J Clin Nutr 57, 11281134.CrossRefGoogle ScholarPubMed
Ek, J (1982) Plasma and red cell folate in mothers and infants in normal pregnancies. Relation to birth weight. Acta Obstet Gynecol Scand 61, 1720.CrossRefGoogle ScholarPubMed
Eskes, TK, Steegers-Theunissen, RP (1994) Primary prevention of neural tube defects with folic acid. Eur J Obstet Gynecol Reprod Biol 53, 147152.CrossRefGoogle ScholarPubMed
Finnell, RH, Gould, A & Spiegelstein, O (2003) Pathobiology and genetics of neural tube defects. Epilepsia 44, 1423.CrossRefGoogle ScholarPubMed
Freeman, JV, Cole, TJ, Chinn, S, Jones, PRM, White, EM & Preece, MA (1995) Cross sectional stature and weight reference curves for the UK, 1990. Arch Dis Child 73, 1724.CrossRefGoogle ScholarPubMed
Goldenberg, RL, Tamura, T, Cliver, SP, Cutter, GR, Hoffman, HJ & Copper, RL (1992) Serum folate and fetal growth retardation: a matter of compliance?. Obstet Gynecol 79, 719722.Google ScholarPubMed
Green, R & Miller, JW (1999) Folate deficiency beyond megaloblastic anemia: hyperhomocysteinemia and other manifestations of dysfunctional folate status. Semin Hematol 36, 4764.Google ScholarPubMed
Guerra-Shinohara, EM, Paiva, AA, Rondo, PH, Yamasaki, K, Terzi, CA, D'Almeida, V (2002) Relationship between total homocysteine and folate levels in pregnant women and their newborn babies according to maternal levels of vitamin B 12. Br J Obstet Gynaecol 109, 784791.CrossRefGoogle Scholar
Hoffbrand, AV & Pettit, JE (1997) Megaloblastic anaemias and other macrocytic anaemias. In Essential Haematology. 3rd ed. 5373Oxford: Blackwell.Google Scholar
Infante-Rivard, C, Rivard, G-E, Gauthier, R & Theoret, Y (2003) Unexpected relationship between plasma homocysteine and intrauterine growth restriction. Clin Chem 49, 14761482.CrossRefGoogle ScholarPubMed
Keen, CL, Hanna, LA, Lanoue, L, Uriu-Adams, JY, Rucker, RB & Clegg, MS (2003) Developmental consequences of trace mineral deficiencies in rodents: acute and long term effects. J Nutr 133, 1477S1480S.CrossRefGoogle ScholarPubMed
Kirke, PN, Molloy, AM, Daly, LE, Burke, H, Weir, DG & Scott, JM (1993) Maternal plasma folate and vitamin B 12 are independent risk factors for neural tube defects. Q J Med 86, 703708.Google ScholarPubMed
Kramer, MS (1987) Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Org 65, 663737.Google ScholarPubMed
Kramer, MS, Goulet, L & Lydon, J (2001) Socio-economic disparities in pre-term birth: causal pathways and mechanisms. Paediatr Perinat Epidemiol 15, Suppl. 2, 104123.CrossRefGoogle Scholar
Lucock, M, Yates, Z, Glanville, T, Leeming, R, Simpson, N & Daskalakis, I (2003) A critical role for B-vitamin nutrition in human development and evolutionary biology. Nutr Rev 23, 14631475.Google Scholar
Mannino, DM, Mulinare, J, Ford, ES & Schwartz, J (2003) Tobacco exposure and decreased serum and red blood cell folate levels: data from the Third National Health and Nutrition Examination Survey. Nicotine Tob Res 5, 397399.CrossRefGoogle ScholarPubMed
McDonald, SD, Perkins, SL, Jodouin, CA & Walker, MC (2002) Folate levels in pregnant women who smoke: an important gene/environment interaction. Am J Obstet Gynecol 187, 620625.CrossRefGoogle ScholarPubMed
Medina, MA, Urdiales, JL, Amores-Sanchez, MI (2001) Roles of homocysteine in cell metabolism: old and new functions. Eur J Biochem 268, 38713882.CrossRefGoogle ScholarPubMed
Molloy, AM, Mills, JL, McPartlin, J, Kirke, PN, Scott, JM & Daly, S (2002) Maternal and fetal plasma homocysteine concentrations at birth: the influence of folate, vitamin B 12, and the 5,10-methylenetetrahydrofolate reductase 677C T variant. J Obstet Gynecol 186, 499503.CrossRefGoogle Scholar
MRC Vitamin Study Research Group (1991) Prevention of neural tube defects: results of the Medical Research Council vitamin study. Lancet 338, 131137.CrossRefGoogle Scholar
Neggers, YH, Goldenberg, RL, Tamura, T, Cliver, SP & Hoffman, HJ (1997) The relationship between maternal dietary intake and infant birthweight. Acta Obstet Gynecol Scand 165, Suppl., 7175.Google ScholarPubMed
Nelen, WLDM, Blom, HJ, Steegers, EAP, den Heijer, M, Thomas, CMG, Eskes, TKAB (2000) Hyperhomocysteinemia and recurrent early pregnancy loss: a meta-analysis. Fertil Steril 74, 11961199.CrossRefGoogle ScholarPubMed
Ortega, RM, Requejo, AM, Lopez-Sobaler, AM, Navia, B, Mena, MC, Basabe, B & Andres, P (2004) Smoking and passive smoking as conditioners of folate status in young women. J Am Coll Nutr 23, 365371.CrossRefGoogle ScholarPubMed
Rao, S, Yajnik, CS & Kanade, A (2001) Intake of micronutrient-rich foods in rural Indian mothers is associated with size of their babies at birth: Pune Maternal Nutrition Study. J Nutr 131, 12171224.CrossRefGoogle ScholarPubMed
Ronnenberg, AG, Goldman, MB, Chen, D, Aitken, IW, Willett, WC, Selhub, J & Xu, X (2002) Preconception homocysteine and B vitamin status and birth outcomes in Chinese women. Am J Clin Nutr 76, 13851391.CrossRefGoogle Scholar
Rosenquist, TH & Finnell, RH (2001) Genes, folate and homocysteine in embryonic development. Proc Nutr Soc 60, 5361.CrossRefGoogle ScholarPubMed
Scholl, TO, Hediger, ML, Scholl, JI, Khoo, CS & Fischer, RL (1996) Dietary and serum folate: their influence on the outcome of pregnancy. Am J Clin Nutr 63, 520525.CrossRefGoogle ScholarPubMed
Scholl, TO & Johnson, WG (2000) Folic acid: influence on the outcome of pregnancy. Am J Clin Nutr 71 1295S – 1303S.CrossRefGoogle ScholarPubMed
Spencer, N (2003) Social and environmental determinants of birthweight. In Weighing the Evidence – How is Birthweight Determined? 87121OxfordRadcliffe Medical Press.Google Scholar
Suarez, L, Hendricks, K, Felkner, M & Gunter, E (2003) Maternal serum B 12 levels and risk for neural tube defects in a Texas–Mexico border population. Ann Epidemiol 13, 8188.CrossRefGoogle Scholar
Swanson, DA, Liu, ML, Baker, PJ, Garrett, L, Stitzel, M, Wu, J, Harris, M, Banerjee, R, Shane, B & Brody, LC (2001) Targeted disruption of the methionine synthase gene in mice. Mol Cell Biol 21, 10581065.CrossRefGoogle ScholarPubMed
Tamura, T, Goldenberg, RL, Johnston, KE, Cliver, SP & Hoffman, SJ (1997) Serum concentrations of zinc, folate, vitamins A and E, and proteins, and their relationship to pregnancy outcome. Acta Obstet Gynecol Scand 76, 6370.Google Scholar
Ueland, PM, Bjorke, Monsen AL (2003) Hyperhomocysteinemia and B-vitamin deficiencies in infants and children. Clin Chem Lab Med 41, 14181426.CrossRefGoogle ScholarPubMed
van der Molen, EF, Verbruggen, B, Nokalova, I, Eskes, TK, Monnens, LA, Blom, HJ (2000) Hyperhomocysteinemia and other thrombotic risk factors in women with placental vasculopathy. Br J Obstet Gynaecol 107, 785791.CrossRefGoogle ScholarPubMed
van Rooij, IA, Swinkels, DW, Blom, HJ, Merkus, HM, Steegers-Theunissen, RP (2003) Vitamin and homocysteine status of mothers and infants and the risk of nonsyndromic orofacial clefts. Am J Obstet Gynecol 189, 11551160.CrossRefGoogle ScholarPubMed
van Wersch, JW, Janssen, Y & Zandvoort, JA (2002) Folic acid, vitamin B 12, and homocysteine in smoking and non-smoking pregnant women. Eur J Obstet Gynecol Reprod Biol 103, 1821.CrossRefGoogle ScholarPubMed
Vollset, SE, Refsum, H, Irgens, LM, Emblem, BM, Tverdal, A, Gjessing, Monsen AL, Ueland, PM (2000) Plasma total homocysteine, pregnancy complications, and adverse pregnancy outcomes: the Hordland Homocysteine Study. Am J Clin Nutr 71, 962968.CrossRefGoogle ScholarPubMed