Imbalanced Folate and Vitamin B12 in the Third Trimester of Pregnancy and its Association with Birthweight and Child Growth up to 2 Years

Short-Term Postnatal Overfeeding Induces Long-Lasting Cardiometabolic Syndrome in Mature and Old Mice Associated with Increased Sensitivity to Myocardial Infarction

SCOPE

Perinatal nutritional disturbances may "program" an increased cardio-metabolic risk in adulthood; however, few experimental studies have explored their effects on mature and/or old animal. This study aims to investigate the influence of postnatal overfeeding (PNOF) on cardiac function, sensitivity to ischemia-reperfusion (I-R) injury in vivo, glucose metabolism, and metabolic profile of pericardial adipose tissue (PAT) in young (4 months), adult (6 months), old (12 months), and very old (18 months) male mice.

METHODS AND RESULTS

Two days after birth, PNOF is induced by adjusting the litter size of C57BL/6 male mice to three pups/mother, while the normally fed (NF) control group is normalized to nine pups/mother. After weaning, all mice have free access to standard diet. Glucose/insulin tests and in vivo myocardial I-R injury are conducted on mice aged from 2 to 12 months, while echocardiography is performed at all ages up to 18 months. PNOF mice exhibit an early and persistent 10-20% increase in body weight and a 10% decrease in left ventricular ejection fraction throughout their lifespan. In PNOF mice aged 4, 6, and 12 months, glucose intolerance and insulin resistance are observed, as well as a 27-34% increase in infarct size. This is accompanied by a higher PAT mass with increased inflammatory status.

CONCLUSION

Short-term PNOF results in nutritional programming, inducing long-lasting alterations in glucose metabolism and cardiac vulnerability in male mice, lasting up to 12 months.

Peri-Conceptional Folic Acid Supplementation and Children’s Physical Development: A Birth Cohort Study

Background: Maternal lack of folic acid supplementation during pregnancy may increase the risk of low birth weight and preterm delivery. However, little is known about the relationship between folic acid supplementation during pregnancy and the physical development of offspring in the later stage. Objective: This study aimed to explore the association between maternal folic acid supplementation status during pregnancy and the physical development of preschool children. Methods: A total of 3064 mother–child pairs with data on maternal folic acid supplementation status during pregnancy and children’s anthropometric measurements were recruited from the Ma’anshan-Anhui Birth Cohort (MABC) in China. Maternal folic acid supplementation status during pregnancy was the main exposure, and the primary outcomes were children’s growth development trajectories. Children’s growth development trajectories were fitted using group-based trajectory models. The association between maternal folic acid supplementation status during pregnancy and children’s growth trajectories was performed using multiple logistic regression models. Results: After adjusting for potential confounders, we found that the absence of maternal folic acid supplementation before pregnancy and in the first trimester was significantly associated with a “high level” trajectory (trajectory 3) and a “high rising level” trajectory (trajectory 4) of BMI-Z scores in children 0 to 6 years of age (OR = 1.423, 95%CI:1.022–1.982; OR = 1.654, 95%CI: 1.024–2.671). In children aged 4 to 6 years old, a “high level” trajectory (trajectory 3) of body fat ratio was substantially related to maternal no folic acid supplementation before pregnancy and in the first trimester (OR = 1.833, 95%CI:1.037–3.240). No significant additional benefits associated with physical developmental indicators in preschool children have been observed with continued folic acid supplementation after the first trimester of gestation. Conclusions: Maternal non-supplementation with folic acid during pregnancy is associated with a “high level” BMI trajectory and a “high level” body fat ratio trajectory in preschool-aged children.

Association of folate and vitamin B12 imbalance with adverse pregnancy outcomes among 11,549 pregnant women: An observational cohort study

Objective

This study aimed to evaluate maternal serum levels of folate, vitamin B12, and their ratio on admission for labor and determine whether an imbalance between folate and vitamin B12, represented by a higher or lower serum folate to vitamin B12 ratio (SFVB12R), was associated with adverse pregnancy outcomes.

Methods

A retrospective cohort study of 11,549 pregnant women attending a district specialized hospital and who had serum folate (SF) and serum vitamin B12 (SVB12) levels measured at delivery was performed. The levels of SF, SVB12, and SFVB12R were defined as high (>95th percentile), normal (5–95th percentile), and low (<5th percentile). Information on pregnancy outcomes was retrieved from medical records. Linear regression was performed to examine the association of abnormal SF, SVB12, and SFVB12R levels with fetal growth indicators. Logistic regression was applied to estimate the association between abnormal SF, SVB12, and SFVB12R levels and pregnancy outcomes.

Results

Lower SF levels were associated with higher risks of intrahepatic cholestasis of pregnancy (ICP, OR 1.58; 95% CI 1.15–2.17), pre-eclampsia (PE, OR 1.89; 95% CI 1.28–2.81), and a lower risk of gestational diabetes mellitus (GDM, OR 0.40; 95% CI 0.23–0.70), whereas higher SVB12 levels were associated with a higher risk of ICP (OR 2.22; 95% CI 1.67–2.96), PE (OR 1.69; 95% CI 1.04-2.74), and GDM (OR 1.62; 95% CI 1.24–2.11). A higher SFVB12R increased birthweight (β 60.99; 95% CI 29.52–92.45) and was associated with a higher risk of large-for-gestational-age (LGA) newborns (OR 3.08; 95% CI 1.63–5.83); a lower SFVB12R decreased birthweight (β −43.81; 95% CI −75.62, −12.00) and was associated with a lower risk of LGA newborns (OR 0.75; 95% CI 0.56–1.00), and with higher risks of ICP (OR 2.03; 95% CI 1.54–2.67) and pregnancy-induced hypertension (PIH, OR 1.81; 95% CI 1.09–3.00).

Conclusion

An imbalance between folate and vitamin B12, represented by a higher or lower SFVB12R before delivery, was significantly associated with adverse pregnancy outcomes (ICP/PIH/LGA).