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Guo W, Li X, Qin K, Zhang P, He J, Liu Y, Yang X, Wu S. Nanopore sequencing demonstrates the roles of spermatozoal DNA N6-methyladenine in mediating transgenerational lipid metabolism disorder induced by excessive folate consumpton. Poult Sci 2024; 103:103953. [PMID: 38945000 PMCID: PMC11267017 DOI: 10.1016/j.psj.2024.103953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 05/31/2024] [Accepted: 06/03/2024] [Indexed: 07/02/2024] Open
Abstract
Increased consumption of folic acid is prevalent due to its beneficial effects, but growing evidence emphasizes the side effects pointing to excessive dietary folate intake. The effects of excessive paternal folic acid consumption on offspring and its transgenerational inheritance mechanism have not been elucidated. We hypothesize that excessive folic acid consumption will alter sperm DNA N6-methyladenine (6mA) and 5-methylcytosine (5mC) methylation and heritably influence offspring metabolic homeostasis. Here, we fed roosters either folic acid-control or folic acid-excess diet throughout life. Paternal chronic folic acid excessive supplementation increased hepatic lipogenesis and lipid accumulation but reduced lipolysis both in the roosters and their offspring, which was further confirmed to be induced by one-carbon metabolism inhibition and gene expression alteration associated with the Peroxisome proliferator-activated receptor pathway. Based on the spermatozoal genome-wide DNA methylome identified by Nanopore sequencing, multi-omics association analysis of spermatozoal and hepatic DNA methylome, transcriptome, and metabolome suggested that differential spermatozoal DNA 6mA and 5mC methylation could be involved in regulating lipid metabolism-related gene expression in offspring chickens. This model suggests that sperm DNA N6-methyladenine and 5-methylcytosine methylation were involved in epigenetic transmission and that paternal dietary excess folic acid leads to hepatic lipid accumulation in offspring.
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Affiliation(s)
- Wei Guo
- Jiangsu Institute of Poultry Science, Yangzhou, Jiangsu Province, 225125, China; College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Xinyi Li
- College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, 712100, China; Department of Medicine, Karolinska Institutet, Solna, Stockholm, 17165, Sweden
| | - Kailong Qin
- College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Peilin Zhang
- College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Jinhui He
- College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Yanli Liu
- College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Xiaojun Yang
- College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Shengru Wu
- College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, 712100, China; Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, 17165, Sweden.
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Kannane S, Touloun O, Boussaa S. The prevalence of neural tube defects and their prevention by folic acid supplementation. Clin Nutr ESPEN 2024; 63:57-67. [PMID: 38923466 DOI: 10.1016/j.clnesp.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 05/17/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND & AIMS Folate is crucial for the development of the fetal neurological system. Moroccan Health authorities promote Folic acid (FA) supplementation, before and during pregnancy, as a significant protection against fetal neural tube defects (NTDs). Thus, the current study aims to investigate the effect of FA supplementation guidelines on NTDs prevalence and to assess the health professionals' (HPs) knowledge, attitude, and practice (KAP) regarding FA supplementation in Morocco. METHODS To assess the prevalence of NTDs, epidemiological data were collected from local and regional medical facilities and enhanced through a literature study. In addition, an auto-administered questionnaire was implemented to evaluate KAP among HPs on the FA supplementation national program. RESULTS The study results showed that from 2017 to 2023, the national prevalence rate of NTDs ranged from 4.26 to 21 per 10,000 live births, according to the region. Lack of information about FA supplementation is evident among HPs; while, 13.7% of the participants confused FA with vitamin B12; merely 50% recognized the significance of FA; and 11.9% had no idea which foods contained the most folate. Consequently, HPs' attitude and practice towards FA supplementation were deemed inadequate. Additionally, only 35.8% of respondents stated that they occasionally inquire about their patients' nutrition, 55.9% do not prescribe FA, and 44.1% are unwilling to report cases of NTDs. CONCLUSION NTDs remain a serious public health problem in Morocco. Despite the significant incidence of these diseases, HPs' knowledge, attitudes and practices in terms of prevention present gaps and inadequacies. According to the results of this study, the preparation of specific training sessions and the start of preconception consultations constitute an urgent and important issue.
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Affiliation(s)
- Soukaina Kannane
- Polydisciplinary Faculty, Sultan Moulay Slimane University, 23000, Beni Mellal, Morocco
| | - Oulaid Touloun
- Polydisciplinary Faculty, Sultan Moulay Slimane University, 23000, Beni Mellal, Morocco
| | - Samia Boussaa
- ISPITS- Higher Institute of Nursing and Health Techniques, Ministry of Health and Social Protection, 10000, Rabat, Morocco.
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Hung CY, Lee HJ, Tsai ZT, Huang SJ, Huang HY, Tsai HJ, Yao TC. Maternal folic acid supplementation during pregnancy in association with childhood overweight or obesity. Obesity (Silver Spring) 2024; 32:1179-1186. [PMID: 38572577 DOI: 10.1002/oby.24012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVE This study aimed to examine associations of maternal folic acid supplementation (FAS) during pregnancy with childhood overweight or obesity (OWO) or adiposity. METHODS In a population-based cohort of 1479 children, maternal FAS during pregnancy was assessed retrospectively by questionnaires. BMI and body fat percentages were measured at a mean age of 6.4 years. Pertinent factors were accounted for in data analyses. RESULTS Maternal FAS during pregnancy was negatively associated with OWO (adjusted odds ratio: 0.70; 95% CI: 0.50 to 0.99). There were inverse associations of maternal FAS during pregnancy with BMI z score (β: -0.22; 95% CI: -0.39 to -0.05), whole body fat percentage (β: -1.28; 95% CI: -2.27 to -0.30), trunk fat percentage (β: -1.41; 95% CI: -2.78 to -0.04), and limb fat percentage (β: -1.31; 95% CI: -2.32 to -0.30). Stratified analyses found inverse associations of FAS during pregnancy with OWO, BMI z score, and body fat percentages predominantly among children without breastfeeding and whose parents had a below-tertiary educational level. CONCLUSIONS This study provides novel evidence that maternal FAS during pregnancy was significantly associated with a decreased risk of childhood OWO and adiposity, particularly among children with no breastfeeding and lower parental educational level.
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Affiliation(s)
- Chi-Yen Hung
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Hsin-Ju Lee
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Pediatrics, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Zhao-Ting Tsai
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shu-Jung Huang
- Department of Pediatrics, Jen-Ai Hospital, Taichung, Taiwan
| | - Hsin-Yi Huang
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Institute of Environmental and Occupational Health Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hui-Ju Tsai
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Tsung-Chieh Yao
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
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Harris ST, Schieve LA, Drews-Botsch C, DiGuiseppi C, Tian LH, Soke GN, Bradley CB, Windham GC. Pregnancy Planning and its Association with Autism Spectrum Disorder: Findings from the Study to Explore Early Development. Matern Child Health J 2024; 28:949-958. [PMID: 38198102 PMCID: PMC11001519 DOI: 10.1007/s10995-023-03877-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVES To examine associations between pregnancy planning and autism spectrum disorder (ASD) in offspring. METHODS The Study to Explore Early Development (SEED), a multi-site case-control study, enrolled preschool-aged children with ASD, other DDs, and from the general population (POP). Some children with DDs had ASD symptoms but did not meet the ASD case definition. We examined associations between mother's report of trying to get pregnant (pregnancy planning) and (1) ASD and (2) ASD symptomatology (ASD group, plus DD with ASD symptoms group combined) (each vs. POP group). We computed odds ratios adjusted for demographic, maternal, health, and perinatal health factors (aORs) via logistic regression. Due to differential associations by race-ethnicity, final analyses were stratified by race-ethnicity. RESULTS Pregnancy planning was reported by 66.4%, 64.8%, and 76.6% of non-Hispanic White (NHW) mothers in the ASD, ASD symptomatology, and POP groups, respectively. Among NHW mother-child pairs, pregnancy planning was inversely associated with ASD (aOR = 0.71 [95% confidence interval 0.56-0.91]) and ASD symptomatology (aOR = 0.67 [0.54-0.84]). Pregnancy planning was much less common among non-Hispanic Black mothers (28-32% depending on study group) and Hispanic mothers (49-56%) and was not associated with ASD or ASD symptomatology in these two race-ethnicity groups. CONCLUSION Pregnancy planning was inversely associated with ASD and ASD symptomatology in NHW mother-child pairs. The findings were not explained by several adverse maternal or perinatal health factors. The associations observed in NHW mother-child pairs did not extend to other race-ethnicity groups, for whom pregnancy planning was lower overall.
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Affiliation(s)
- Shericka T Harris
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop S106-4, Atlanta, GA, 30341, USA.
| | - Laura A Schieve
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop S106-4, Atlanta, GA, 30341, USA
| | - Carolyn Drews-Botsch
- Department of Global and Community Health, College of Health and Human Services, George Mason University, 4400 University Drive, MS: 5B7, Fairfax, VA, 22030, USA
| | - Carolyn DiGuiseppi
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 80045, Aurora, CO, USA
| | - Lin H Tian
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop S106-4, Atlanta, GA, 30341, USA
| | - Gnakub N Soke
- Center for Global Health, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Chyrise B Bradley
- Gillings School of Global Public Health, The University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Gayle C Windham
- California Department of Public Health, Environmental Health Investigations Branch, Richmond, CA, 94804, USA
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Kok DE, Saunders R, Nelson A, Smith D, Ford D, Mathers JC, McKay JA. Influence of maternal folate depletion on Art3 DNA methylation in the murine adult brain; potential consequences for brain and neurocognitive health. Mutagenesis 2024; 39:196-204. [PMID: 38417824 PMCID: PMC11040152 DOI: 10.1093/mutage/geae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/27/2024] [Indexed: 03/01/2024] Open
Abstract
The developmental origins of health and disease hypothesis suggest early-life environment impacts health outcomes throughout the life course. In particular, epigenetic marks, including DNA methylation, are thought to be key mechanisms through which environmental exposures programme later-life health. Adequate maternal folate status before and during pregnancy is essential in the protection against neural tube defects, but data are emerging that suggest early-life folate exposures may also influence neurocognitive outcomes in childhood and, potentially, thereafter. Since folate is key to the supply of methyl donors for DNA methylation, we hypothesize that DNA methylation may be a mediating mechanism through which maternal folate influences neurocognitive outcomes. Using bisulphite sequencing, we measured DNA methylation of five genes (Art3, Rsp16, Tspo, Wnt16, and Pcdhb6) in the brain tissue of adult offspring of dams who were depleted of folate (n = 5, 0.4 mg folic acid/kg diet) during pregnancy (~19-21 days) and lactation (mean 22 days) compared with controls (n = 6, 2 mg folic acid/kg diet). Genes were selected as methylation of their promoters had previously been found to be altered by maternal folate intake in mice and humans across the life course, and because they have potential associations with neurocognitive outcomes. Maternal folate depletion was significantly associated with Art3 gene hypomethylation in subcortical brain tissue of adult mice at 28 weeks of age (mean decrease 6.2%, P = .03). For the other genes, no statistically significant differences were found between folate depleted and control groups. Given its association with neurocognitive outcomes, we suggest Art3 warrants further study in the context of lifecourse brain health. We have uncovered a potential biomarker that, once validated in accessible biospecimens and human context, may be useful to track the impact of early-life folate exposure on later-life neurocognitive health, and potentially be used to develop and monitor the effects of interventions.
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Affiliation(s)
- Dieuwertje E Kok
- Division of Human Nutrition and Health, Wageningen University & Research, P.O. Box 17, 6700 AA Wageningen Stippeneng 4, 6708 WE Wageningen Wageningen Campus l Building 124 (Helix), Wageningen, The Netherlands
| | - Rachael Saunders
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Northumberland Building, Newcastle Upon Tyne, NE1 8ST, United Kingdom
| | - Andrew Nelson
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Northumberland Building, Newcastle Upon Tyne, NE1 8ST, United Kingdom
| | - Darren Smith
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Northumberland Building, Newcastle Upon Tyne, NE1 8ST, United Kingdom
| | - Dianne Ford
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Northumberland Building, Newcastle Upon Tyne, NE1 8ST, United Kingdom
| | - John C Mathers
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Room M2.060, 2nd floor William Leech Building, Framlington Place, Newcastle upon Tyne, NE2 4HH, United Kingdom
| | - Jill A McKay
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Northumberland Building, Newcastle Upon Tyne, NE1 8ST, United Kingdom
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Zhou Z, Wang M, Fan Q, Zhao Y, Wang N. The function of chemical folic acid in calibration methods and neurodevelopmental disorders. Front Chem 2024; 12:1355848. [PMID: 38456186 PMCID: PMC10917952 DOI: 10.3389/fchem.2024.1355848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 01/31/2024] [Indexed: 03/09/2024] Open
Abstract
Functional molecules have been attracting increasing attention in environmental and physiological studies. In particular, folic acid (FA) could be considered a key factor in estimating, adjusting, and making decisions in the treatment of neurodevelopmental disorders. It promotes the general significance and conceptual for considering FA molecular scientific research detections, which implies related advancement in both of biological structure and detection methods. Among these applications, the FA molecule acts as a coenzyme that incorporates carbon atoms and synthesizes purines and pyrimidines. Therefore, the calibration method has real applications and can be used as a sensing platform and for detection approaches, which conveys the internal relationship between the FA molecule and physiological characterization. This mini review briefly discusses multiple FA application fields and detection pathways and could supplement their utilization in anticipation of the onset of disease.
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Affiliation(s)
- Ziqi Zhou
- Department of Children Healthcare, Chongqing Health Center for Women and Children, Chongqing, China
| | - Meng Wang
- Child and Adolescent Department of Chongqing Mental Health Center, Chongqing, China
| | - Qiongli Fan
- Department of Pediatrics, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Yan Zhao
- Department of Children Healthcare, Chongqing Health Center for Women and Children, Chongqing, China
| | - Nianrong Wang
- Department of Children Healthcare, Chongqing Health Center for Women and Children, Chongqing, China
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Fraga ACSA, Bastos MP, Theme-Filha MM. Increased consumption of ultra-processed foods during pregnancy is associated with sociodemographic, behavioral, and obstetric factors: A cohort study. Nutr Res 2024; 121:28-38. [PMID: 38039599 DOI: 10.1016/j.nutres.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/28/2023] [Accepted: 10/28/2023] [Indexed: 12/03/2023]
Abstract
A diet based on ultra-processed food (UPF) does not meet nutritional needs, especially during pregnancy. The aim of this study is to assess the change in UPF consumption from preconception to pregnancy and associated factors. Our hypothesis is that women tend to adopt a healthier eating pattern during pregnancy, decreasing the intake of UPF and increasing the intake of unprocessed/minimally processed foods. A prospective cohort study with 326 participants was carried out from 2016 to 2019 in 2 health units in Rio de Janeiro, Brazil. Pregestational food consumption assessed using the food frequency questionnaire in the prenatal interview in women up to 20 gestational weeks and gestational consumption in the interview 2 months after delivery. Food items classified according to the NOVA system. For the mean variation from preconception to gestational UPF consumption, we used the generalized estimating equations model with linear distribution. Control of confounding variables was based on the literature on factors associated with UPF consumption, using a 3-level hierarchical model. The proportion of UPF energy consumption was 28.9% in preconception and 33% during pregnancy. Older and more educated women had a lower mean variation in the consumption of UPF during the pregnancy. A higher average consumption of UPF observed among women physically inactive before pregnancy, who smoked during pregnancy, were multiparous, and with had a low pregestational weight. These results reflect similar behavior to that of the general population, aggravated by a significant increase during pregnancy. However, older and more educated women and those with healthy behaviors showed lower UPF intake in pregnancy.
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Chen Q, Liu XL, Lin LZ, Wang X, Li MH, Dai MX, Cao MQ, Li XH, Jin J, Xu HQ, Cai L. Associations of unintended pregnancy with autism spectrum disorders and the modification of folic acid supplements. Autism Res 2024; 17:172-181. [PMID: 38131613 DOI: 10.1002/aur.3070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 11/12/2023] [Indexed: 12/23/2023]
Abstract
There is limited evidence on the associations of unintended pregnancy with autism spectrum disorders (ASD). This study aimed to examine this relationship and the modification of pre-conceptional and prenatal folic acid supplements. Six thousand and five toddlers aged 16 to 30 months from seven cities of six provinces in China were eligible for participation. Information on unintended pregnancy and folic acid supplements was obtained via questionnaires from caregivers of toddlers. The diagnosis of ASD was based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the Chinese version of the Childhood Autism Rating Scale (CARS). Of the 6005 toddlers in the study (3337 boys and 2668 girls), 71 (1.18%) received the diagnosis of ASD. Generalized linear models with a logit link function showed unintended pregnancy was positively associated with ASD (odds ratios [OR] = 1.69, 95% confidence interval [CI], 1.05-2.79). Stratified estimates indicated that the association remained stable among toddlers of mothers without pre-conceptional and prenatal folic acid supplements (OR = 2.75, 95% CI, 1.04-7.27; n = 1243, 20.70%). Unintended pregnancy was associated with higher odds of ASD in 16-30 months of toddlers, and the association was consistent among toddlers of mothers without prenatal folic acid supplements. Our findings emphasize the need to raise awareness of the risk of unintended pregnancy and the benefits of folic acid supplements among Chinese women.
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Affiliation(s)
- Qian Chen
- Department of Neonatology, Guangzhou Key Laboratory of Neonatal Intestinal Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Xing-Lian Liu
- Department of Child Health Care, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, People's Republic of China
| | - Li-Zi Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Xin Wang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Ming-Hui Li
- Department of Child Health Care, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, People's Republic of China
| | - Mei-Xia Dai
- Department of Children's Healthcare and Mental Health Center, Shenzhen Children's Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Mu-Qing Cao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Xiu-Hong Li
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Jing Jin
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Hai-Qing Xu
- Department of Child Health Care, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, People's Republic of China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
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Bjørke-Monsen AL, Ueland PM. Folate - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2023; 67:10258. [PMID: 38187793 PMCID: PMC10770645 DOI: 10.29219/fnr.v67.10258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/29/2022] [Accepted: 09/27/2023] [Indexed: 01/09/2024] Open
Abstract
Folate is an essential micronutrient for normal development and metabolic function, and folate deficiency is associated with an increased risk of cancer, cardiovascular disease, mental dysfuntion and negative pregnancy outcomes. When estimating folate requirements, one must consider different bioavailability and functionality between synthetic folic acid and dietary folate, together with increased needs of folate in women of fertile age, pregnant and lactating women, preterm and small for gestational age weight infants and individuals who are homozygote for the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene polymorphism. In order to achieve an adequate metabolic status based on the metabolic marker total homocysteine, and not merely the absence of clinical signs of folate deficiency, the recommended intake of folate differs according to age, pregnancy and lactation. According to the World Health Organization, a decision limit for folate deficiency in adults is serum folate level below 10 nmol/L, and in women of fertile age a red blood cell folate level below 906 nmol/L in order to prevent neural tube defects. Qualified systematic reviews along with identified relevant literature have been used for this scoping review prepared for the Nordic Nutrition Recommendations 2023.
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Affiliation(s)
- Anne-Lise Bjørke-Monsen
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Per Magne Ueland
- Department of Clinical Science, University of Bergen, Bergen, Norway
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10
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Boerma T, Ter Haar S, Ganga R, Wijnen F, Blom E, Wierenga CJ. What risk factors for Developmental Language Disorder can tell us about the neurobiological mechanisms of language development. Neurosci Biobehav Rev 2023; 154:105398. [PMID: 37741516 DOI: 10.1016/j.neubiorev.2023.105398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/03/2023] [Accepted: 09/17/2023] [Indexed: 09/25/2023]
Abstract
Language is a complex multidimensional cognitive system that is connected to many neurocognitive capacities. The development of language is therefore strongly intertwined with the development of these capacities and their neurobiological substrates. Consequently, language problems, for example those of children with Developmental Language Disorder (DLD), are explained by a variety of etiological pathways and each of these pathways will be associated with specific risk factors. In this review, we attempt to link previously described factors that may interfere with language development to putative underlying neurobiological mechanisms of language development, hoping to uncover openings for future therapeutical approaches or interventions that can help children to optimally develop their language skills.
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Affiliation(s)
- Tessel Boerma
- Institute for Language Sciences, Department of Languages, Literature and Communication, Utrecht University, Utrecht, the Netherlands
| | - Sita Ter Haar
- Institute for Language Sciences, Department of Languages, Literature and Communication, Utrecht University, Utrecht, the Netherlands; Cognitive Neurobiology and Helmholtz Institute, Department of Psychology, Utrecht University/Translational Neuroscience, University Medical Center Utrecht, the Netherlands
| | - Rachida Ganga
- Institute for Language Sciences, Department of Languages, Literature and Communication, Utrecht University, Utrecht, the Netherlands
| | - Frank Wijnen
- Institute for Language Sciences, Department of Languages, Literature and Communication, Utrecht University, Utrecht, the Netherlands
| | - Elma Blom
- Department of Development and Education of youth in Diverse Societies (DEEDS), Utrecht University, Utrecht, the Netherlands; Department of Language and Culture, The Arctic University of Norway UiT, Tromsø, Norway.
| | - Corette J Wierenga
- Biology Department, Faculty of Science, Utrecht University, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.
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11
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Sainty R, Silver MJ, Prentice AM, Monk D. The influence of early environment and micronutrient availability on developmental epigenetic programming: lessons from the placenta. Front Cell Dev Biol 2023; 11:1212199. [PMID: 37484911 PMCID: PMC10358779 DOI: 10.3389/fcell.2023.1212199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/27/2023] [Indexed: 07/25/2023] Open
Abstract
DNA methylation is the most commonly studied epigenetic mark in humans, as it is well recognised as a stable, heritable mark that can affect genome function and influence gene expression. Somatic DNA methylation patterns that can persist throughout life are established shortly after fertilisation when the majority of epigenetic marks, including DNA methylation, are erased from the pre-implantation embryo. Therefore, the period around conception is potentially critical for influencing DNA methylation, including methylation at imprinted alleles and metastable epialleles (MEs), loci where methylation varies between individuals but is correlated across tissues. Exposures before and during conception can affect pregnancy outcomes and health throughout life. Retrospective studies of the survivors of famines, such as those exposed to the Dutch Hunger Winter of 1944-45, have linked exposures around conception to later disease outcomes, some of which correlate with DNA methylation changes at certain genes. Animal models have shown more directly that DNA methylation can be affected by dietary supplements that act as cofactors in one-carbon metabolism, and in humans, methylation at birth has been associated with peri-conceptional micronutrient supplementation. However, directly showing a role of micronutrients in shaping the epigenome has proven difficult. Recently, the placenta, a tissue with a unique hypomethylated methylome, has been shown to possess great inter-individual variability, which we highlight as a promising target tissue for studying MEs and mixed environmental exposures. The placenta has a critical role shaping the health of the fetus. Placenta-associated pregnancy complications, such as preeclampsia and intrauterine growth restriction, are all associated with aberrant patterns of DNA methylation and expression which are only now being linked to disease risk later in life.
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Affiliation(s)
- Rebecca Sainty
- Biomedical Research Centre, School of Biological Sciences, University of East Anglia, Norwich, United Kingdom
| | - Matt J. Silver
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Andrew M. Prentice
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, Gambia
| | - David Monk
- Biomedical Research Centre, School of Biological Sciences, University of East Anglia, Norwich, United Kingdom
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Nishigori H, Nishigori T, Obara T, Suzuki T, Mori M, Imaizumi K, Murata T, Kyozuka H, Ogata Y, Sato A, Shinoki K, Yasumura S, Hosoya M, Hashimoto K, Fujimori K. Prenatal folic acid supplement/dietary folate and cognitive development in 4-year-old offspring from the Japan Environment and Children's Study. Sci Rep 2023; 13:9541. [PMID: 37308528 DOI: 10.1038/s41598-023-36484-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 06/05/2023] [Indexed: 06/14/2023] Open
Abstract
We evaluated the association between maternal prenatal folic acid supplement use/dietary folate intake and cognitive development in 4-year-old offspring (N = 3445) using data from the Japan Environment and Children's Study. Cognitive development was evaluated using the Kyoto Scale of Psychological Development 2001. Multiple regression analysis revealed that offspring of mothers who started using folic acid supplements pre-conception had a significantly higher language-social developmental quotient (DQ) (partial regression coefficient 1.981, 95% confidence interval 0.091 to 3.872) than offspring of mothers who did not use such supplements at any time throughout their pregnancy (non-users). Offspring of mothers who started using folic acid supplements within 12 weeks of gestation had a significantly higher cognitive-adaptive (1.489, 0.312 to 2.667) and language-social (1.873, 0.586 to 3.159) DQ than offspring of non-users. Regarding daily dietary folate intake from preconception to early pregnancy, multiple regression analysis revealed that there was no significant association with any DQ area in the 200 to < 400 µg and the ≥ 400 µg groups compared with the < 200 µg group. Maternal prenatal folic acid supplementation starting within 12 weeks of gestation (but not adequate dietary folate intake from preconception to early pregnancy) is positively associated with cognitive development in 4-year-old offspring.
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Affiliation(s)
- Hidekazu Nishigori
- Department of Development and Environmental Medicine, Fukushima Medical Center for Children and Women, Fukushima Medical University Graduate School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima, 960‑1295, Japan.
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan.
| | - Toshie Nishigori
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Taku Obara
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Taeko Suzuki
- Department of Development and Environmental Medicine, Fukushima Medical Center for Children and Women, Fukushima Medical University Graduate School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima, 960‑1295, Japan
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Maternal Nursing and Midwifery, Fukushima Medical University School of Nursing, Fukushima, Japan
- Department of Maternal Nursing, Fukushima Medical University Graduate School of Nursing, Fukushima, Japan
| | - Miyuki Mori
- Department of Development and Environmental Medicine, Fukushima Medical Center for Children and Women, Fukushima Medical University Graduate School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima, 960‑1295, Japan
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Maternal Nursing and Midwifery, Fukushima Medical University School of Nursing, Fukushima, Japan
- Department of Maternal Nursing, Fukushima Medical University Graduate School of Nursing, Fukushima, Japan
| | - Karin Imaizumi
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tsuyoshi Murata
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hyo Kyozuka
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yuka Ogata
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
| | - Akiko Sato
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
| | - Kosei Shinoki
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
| | - Seiji Yasumura
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mitsuaki Hosoya
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Koichi Hashimoto
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Keiya Fujimori
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
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13
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Ulziikhuu B, Gombojav E, Banzrai C, Batsukh S, Enkhtuya E, Boldbaatar B, Bellinger DC, Lanphear BP, McCandless LC, Nepomnaschy P, Salvante K, Weinberg J, Allen RW. Who benefits most from a prenatal HEPA filter air cleaner intervention on childhood cognitive development? The UGAAR randomized controlled trial. ENVIRONMENTAL RESEARCH 2023; 231:115991. [PMID: 37121346 DOI: 10.1016/j.envres.2023.115991] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/05/2023] [Accepted: 04/24/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Air pollution exposure during pregnancy affects children's brain function. Maternal stress and nutrition, socioeconomic status, and the child's sex may modify this relationship. OBJECTIVE To identify characteristics of children with the largest increases in full-scale IQ (FSIQ) after their mothers used HEPA filter air cleaners during pregnancy. METHODS In this randomized controlled trial we randomly assigned women to receive 1-2 air cleaners or no air cleaners during pregnancy. We analyzed maternal hair samples for cortisol and dehydroepiandrosterone (DHEA). When the children were 48 months old, we measured FSIQ with the Wechsler Preschool and Primary Scale of Intelligence. We evaluated ten potential modifiers of the intervention-FSIQ relationship using interaction terms in separate regression models. To account for correlations between modifiers, we also used a single regression model containing main effects and intervention x modifier terms for all potential modifiers. RESULTS Among 242 mother-child dyads with complete data, the intervention was associated with a 2.3-point increase (95% CI: -1.5, 6.0 points) in mean FSIQ. The intervention improved mean FSIQ among children of mothers in the bottom (5.4 points; 95% CI: -0.8, 11.5) and top (6.1 points; 95% CI: 0.5, 11.8) cortisol tertiles, but not among those whose mothers were in the middle tertile. The largest between-group difference in the intervention's effect was a 7.5-point (95% CI: -0.7, 15.7) larger increase in mean FSIQ among children whose mothers did not take vitamins than among children whose mothers did take vitamins (interaction p-value = 0.07). We also observed larger benefits among children whose mothers did not complete university, and those with lower hair DHEA concentrations, hair cortisol concentrations outside the middle tertile, or more perceived stress. CONCLUSION The benefits of reducing air pollution during pregnancy on brain development may be greatest for children whose mothers who do not take vitamins, experience more stress, or have less education.
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Affiliation(s)
| | | | | | - Sarangerel Batsukh
- Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Enkhtuul Enkhtuya
- Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | | | | | | | | | | | | | - Joanne Weinberg
- University of British Columbia, Faculty of Medicine, Vancouver, BC, Canada
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14
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Zhu Z, Zhu Y, Wang L, Qi Q, Huang L, Andegiorgish AK, Elhoumed M, Cheng Y, Dibley MJ, Sudfeld CR, Zeng L. Effects of antenatal micronutrient supplementation regimens on adolescent emotional and behavioral problems: A 14-year follow-up of a double-blind, cluster-randomized controlled trial. Clin Nutr 2023; 42:129-135. [PMID: 36527827 DOI: 10.1016/j.clnu.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/14/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Antenatal multiple micronutrient supplementation has been shown to have beneficial effects on birth outcomes and may improve child development. However, whether there is an effect of antenatal micronutrient supplementation strategies on offspring socioemotional outcomes remains unknown. We aimed to examine the effect of antenatal folic acid (FA), iron-folic acid (IFA), and multiple micronutrient (MMN) supplementation on adolescent emotional and behavioral outcomes. METHODS We conducted a double-blind, cluster-randomized trial of antenatal micronutrient supplementation in rural western China between 2002 and 2006. Pregnant females were randomized by village to receive either daily (i) 400 μg FA, (ii) IFA containing 60 mg iron and 400 μg FA or (iii) MMN supplementation containing 30 mg iron, 400 μg FA plus 13 additional vitamins and minerals. A 14-year follow-up of their offspring was conducted in 2016. Adolescents were administered the locally adapted Youth Self-Report-2001 (YSR-2001) which produced internalizing, externalizing, and total behavior problem scores. We applied generalized estimating equations to assess the effect of the randomized regimens on YSR-2001 scores and explored the potential effect modification by household wealth and initial timing and duration of supplementation. RESULTS A total of 1920 adolescents were included in the analysis, 1130 (58.9%) were male, and the mean (SD) age was 11.8 (0.78) years. Adolescents in IFA group had lower total (mean difference (MD): -2.89; 95% CI -5.73, -0.04) and externalizing (MD: -0.97; 95% CI -1.79, -0.15) problem scores as compared to those in FA group. There was no effect of MMN on behavior problem scores as compared to IFA and FA alone. Although, in effect modification analyses, MMN appeared to have greater beneficial effects in wealthier households than IFA and FA alone. CONCLUSIONS Iron supplementation during pregnancy reduced adolescent emotional and behavioral problem scores which provides additional support for expanding coverage of iron-containing prenatal supplements in resource-limited settings. TRIAL REGISTRATION isrctn. org Identifier: ISRCTN08850194.
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Affiliation(s)
- Zhonghai Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Yingze Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Liang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Qi Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Lin Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Amanuel Kidane Andegiorgish
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Mohamed Elhoumed
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Yue Cheng
- Department of Nutrition and Food Safety Research, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Michael J Dibley
- The Sydney School of Public Health, Faculty of Medicine, The University of Sydney, NSW, Australia
| | - Christopher R Sudfeld
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lingxia Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China; Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, Xi'an, Shaanxi, PR China.
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15
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Folate in maternal rheumatoid arthritis-filial autism spectrum disorder continuum. Reprod Toxicol 2023; 115:29-35. [PMID: 36402436 DOI: 10.1016/j.reprotox.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022]
Abstract
Rheumatoid Arthritis (RA) is an inflammatory autoimmune disease that affects women three times more than men. Epidemiological studies found that the incidence of Autism Spectrum Disorder (ASD), a neurological and developmental disorder, in children born to mothers suffering from RA is higher compared with the control population. Considering that the pathogenesis of ASD could be traced back to pregnancy and in uterine conditions, and the evidence of reduced folate levels in the brain of ASD-affected children, we aimed to study the role of folate, as an important nutritional factor during pregnancy, in associating maternal RA to ASD development in the offspring. Folate balance during RA could be influenced twice, initially during the immune activation associated with disease onset, and later during the treatment with anti-folate drugs, with a potential consequence of folate deficiency. Maternal folate deficiency during pregnancy could increase homocysteine levels, oxidative stress, and global DNA hypomethylation, all known risk factors in ASD pathogenesis. These effects could be intensified by genetic polymorphisms in the folate system, which were also found as genetic risk factors for both RA and ASD. The available evidence suggests that folate level as an important factor during RA, pregnancy and ASD could have pathological and therapeutical significance and should be carefully monitored and investigated in the RA-pregnancy-ASD axis.
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Maternal folic acid supplement use/dietary folate intake from preconception to early pregnancy and neurodevelopment in 2-year-old offspring: the Japan Environment and Children's Study. Br J Nutr 2022; 128:2480-2489. [PMID: 35115066 DOI: 10.1017/s000711452200037x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We evaluated the association between maternal prenatal folic acid supplementation/dietary folate intake and motor and cognitive development in 2-year-old offspring using data from the Japan Environment and Children's Study database. Neurodevelopment of 2-year-old offspring were evaluated using the Kyoto Scale of Psychological Development 2001. In total, data of 3839 offspring were analysed. For folic acid supplementation, a multiple regression analysis showed that offspring of mothers who started using folic acid supplements before conception had a significantly lower developmental quotient (DQ) in the postural-motor DQ area than offspring of mothers who did not use them at any time throughout their pregnancy (partial regression coefficient (B) -2·596, 95 % CI -4·738, -0·455). Regarding daily dietary folate intake from preconception to early pregnancy, a multiple regression analysis showed that the group with ≥ 200 µg had a significantly higher DQ in the language-social area than the group with <200 µg. The DQ was higher in the ≥ 400 µg group (B 2·532, 95 % CI 0·201, 4·863) than the 200 to <400 µg group (B 1·437, 95 % CI 0·215, 2·660). In conclusion, our study showed that maternal adequate dietary folate intake from preconception to early pregnancy has a beneficial association with verbal cognition development in 2-year-old offspring. On the other hand, mothers who started using folic acid supplements before conception had an inverse association with motor development in 2-year-old offspring. There were no details on the amount of folic acid in the supplements used and frequency of use. Therefore, further studies are required.
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Abstract
This research evaluates the prevalence of inadequate folate status in early pregnancy, the pattern of prenatal folic acid (FA) supplementation and associated factors in Spanish pregnant women from the ECLIPSES study, which included 791 participants prior gestational week 12. A cross-sectional evaluation of erythrocyte folate levels was performed at recruitment and used to calculate the prevalence of folate deficiency (erythrocyte folate < 340 nmol/l) and insufficiency (erythrocyte folate < 906 nmol/l). Sociodemographic and lifestyle data as well as information on prenatal FA supplementation were recorded. Descriptive and multivariate statistical analyses were performed. The prevalence of folate deficiency and insufficiency were 9·6 % and 86·5 %, respectively. Most of women used prenatal FA supplements, but only 6·3 % did so as recommended. Supplementation with FA during the periconceptional period abolished folate deficiency and reduced folate insufficiency. Prenatal FA supplementation with ≥1000 µg/d in periconceptional time and pregnancy planning increased erythrocyte folate levels. The main risk factor for folate insufficiency in early pregnancy was getting prenatal FA supplementation out of the periconceptional time (OR 3·32, 95 % CI 1·02, 15·36), while for folate deficiency they were young age (OR 2·02, 95 % CI 1·05, 3·99), and smoking (OR 2·39, 95 % CI 1·30, 4·37). In addition, social and ethnic differences according to folate status were also identified. As conclusion, periconceptional FA use is crucial for achieving optimal folate levels in early pregnancy. Pregnancy planning should focus on young women, smokers, those with low consumption of folate-rich foods, low socio-economic status or from ethnic minorities.
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Alvestad S, Husebye ESN, Christensen J, Dreier JW, Sun Y, Igland J, Leinonen MK, Gissler M, Gilhus NE, Tomson T, Bjørk M. Folic Acid and Risk of Preterm Birth, Preeclampsia, and Fetal Growth Restriction Among Women With Epilepsy: A Prospective Cohort Study. Neurology 2022; 99:e605-e615. [PMID: 35577577 PMCID: PMC9442624 DOI: 10.1212/wnl.0000000000200669] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 03/16/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Women with epilepsy treated with antiseizure medication (ASM) have increased risk of pregnancy complications including preterm birth, fetal growth restriction, and preeclampsia. We aimed to investigate whether folic acid supplementation is associated with these pregnancy complications in women with epilepsy using ASM. METHODS Singleton pregnancies in the prospective Norwegian Mother and Child Cohort Study (MoBa) (1999-2008) were included. Information on maternal epilepsy, ASM, folic acid supplementation, and pregnancy outcomes was obtained from the MoBa questionnaires and the Norwegian Medical Birth Registry. The main exposure, periconceptional folic acid supplementation, was defined as intake between 4 weeks before pregnancy and 12 weeks into pregnancy, retrospectively collected by recall of the mothers in weeks 17-19. The primary outcomes were preterm birth (gestational age <37 weeks at birth), small for gestational age (SGA), and preeclampsia. RESULTS The study included 100,105 pregnancies: 99,431 without maternal epilepsy, 316 with maternal epilepsy and ASM exposure in pregnancy, and 358 with untreated maternal epilepsy. Among ASM-treated women with epilepsy, the risk of preterm birth was higher in those who did not use periconceptional folic acid (n = 64) compared with those who did (n = 245, the reference) (adjusted odds ratio [aOR] 3.3, 95% CI 1.2-9.2), while the risk of preterm birth among the reference was similar to the risk among women without epilepsy using folic acid periconceptionally (aOR 0.9, 95% CI 0.5-1.6). ASM-treated women with epilepsy starting folic acid after the first trimester had a higher risk compared with women without epilepsy with similar timing of folic acid (aOR 2.6, 95% CI 1.1-6.5), and even higher if not using folic acid (aOR 9.4, 95% CI 2.6-34.8). Folic acid was not associated with risk of preterm birth among women with epilepsy without ASM or among women without epilepsy. Folic acid was not associated with risk of preeclampsia or SGA among women with epilepsy. DISCUSSION In women with epilepsy using ASM, periconceptional folic acid was associated with a lower risk of preterm birth. This finding supports the recommendation that ASM-treated women with epilepsy of childbearing potential should use folic acid supplementation on a regular basis. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that for women with epilepsy using ASM, periconceptional folic acid supplementation decreases the risk of preterm birth.
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Affiliation(s)
- Silje Alvestad
- From the Department of Clinical Medicine (S.A., E.S.N.H., J.W.D., N.E.G., M.B.), University of Bergen; National Center for Epilepsy (S.A.), Oslo; Department of Neurology (E.S.N.H., N.E.G., M.B.), Haukeland University Hospital, Bergen, Norway; Department of Neurology (J.C., Y.S.), and National Centre for Register-Based Research (J.C., J.W.D., Y.S.), Aarhus University, Denmark; Core Facility for Biostatistics and Data Analysis (J.I.), Department of Global Public Health and Primary Care, University of Bergen, Norway; Department of Knowledge Brokers (M.K.L., M.G.), Finnish Institute for Health and Welfare (THL), Helsinki, Finland; Departments of Molecular Medicine and Surgery (M.G.), Clinical Neuroscience (T.T.), and Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden.
| | - Elisabeth Synnøve Nilsen Husebye
- From the Department of Clinical Medicine (S.A., E.S.N.H., J.W.D., N.E.G., M.B.), University of Bergen; National Center for Epilepsy (S.A.), Oslo; Department of Neurology (E.S.N.H., N.E.G., M.B.), Haukeland University Hospital, Bergen, Norway; Department of Neurology (J.C., Y.S.), and National Centre for Register-Based Research (J.C., J.W.D., Y.S.), Aarhus University, Denmark; Core Facility for Biostatistics and Data Analysis (J.I.), Department of Global Public Health and Primary Care, University of Bergen, Norway; Department of Knowledge Brokers (M.K.L., M.G.), Finnish Institute for Health and Welfare (THL), Helsinki, Finland; Departments of Molecular Medicine and Surgery (M.G.), Clinical Neuroscience (T.T.), and Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden
| | - Jakob Christensen
- From the Department of Clinical Medicine (S.A., E.S.N.H., J.W.D., N.E.G., M.B.), University of Bergen; National Center for Epilepsy (S.A.), Oslo; Department of Neurology (E.S.N.H., N.E.G., M.B.), Haukeland University Hospital, Bergen, Norway; Department of Neurology (J.C., Y.S.), and National Centre for Register-Based Research (J.C., J.W.D., Y.S.), Aarhus University, Denmark; Core Facility for Biostatistics and Data Analysis (J.I.), Department of Global Public Health and Primary Care, University of Bergen, Norway; Department of Knowledge Brokers (M.K.L., M.G.), Finnish Institute for Health and Welfare (THL), Helsinki, Finland; Departments of Molecular Medicine and Surgery (M.G.), Clinical Neuroscience (T.T.), and Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden
| | - Julie Werenberg Dreier
- From the Department of Clinical Medicine (S.A., E.S.N.H., J.W.D., N.E.G., M.B.), University of Bergen; National Center for Epilepsy (S.A.), Oslo; Department of Neurology (E.S.N.H., N.E.G., M.B.), Haukeland University Hospital, Bergen, Norway; Department of Neurology (J.C., Y.S.), and National Centre for Register-Based Research (J.C., J.W.D., Y.S.), Aarhus University, Denmark; Core Facility for Biostatistics and Data Analysis (J.I.), Department of Global Public Health and Primary Care, University of Bergen, Norway; Department of Knowledge Brokers (M.K.L., M.G.), Finnish Institute for Health and Welfare (THL), Helsinki, Finland; Departments of Molecular Medicine and Surgery (M.G.), Clinical Neuroscience (T.T.), and Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden
| | - Yuelian Sun
- From the Department of Clinical Medicine (S.A., E.S.N.H., J.W.D., N.E.G., M.B.), University of Bergen; National Center for Epilepsy (S.A.), Oslo; Department of Neurology (E.S.N.H., N.E.G., M.B.), Haukeland University Hospital, Bergen, Norway; Department of Neurology (J.C., Y.S.), and National Centre for Register-Based Research (J.C., J.W.D., Y.S.), Aarhus University, Denmark; Core Facility for Biostatistics and Data Analysis (J.I.), Department of Global Public Health and Primary Care, University of Bergen, Norway; Department of Knowledge Brokers (M.K.L., M.G.), Finnish Institute for Health and Welfare (THL), Helsinki, Finland; Departments of Molecular Medicine and Surgery (M.G.), Clinical Neuroscience (T.T.), and Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden
| | - Jannicke Igland
- From the Department of Clinical Medicine (S.A., E.S.N.H., J.W.D., N.E.G., M.B.), University of Bergen; National Center for Epilepsy (S.A.), Oslo; Department of Neurology (E.S.N.H., N.E.G., M.B.), Haukeland University Hospital, Bergen, Norway; Department of Neurology (J.C., Y.S.), and National Centre for Register-Based Research (J.C., J.W.D., Y.S.), Aarhus University, Denmark; Core Facility for Biostatistics and Data Analysis (J.I.), Department of Global Public Health and Primary Care, University of Bergen, Norway; Department of Knowledge Brokers (M.K.L., M.G.), Finnish Institute for Health and Welfare (THL), Helsinki, Finland; Departments of Molecular Medicine and Surgery (M.G.), Clinical Neuroscience (T.T.), and Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden
| | - Maarit K Leinonen
- From the Department of Clinical Medicine (S.A., E.S.N.H., J.W.D., N.E.G., M.B.), University of Bergen; National Center for Epilepsy (S.A.), Oslo; Department of Neurology (E.S.N.H., N.E.G., M.B.), Haukeland University Hospital, Bergen, Norway; Department of Neurology (J.C., Y.S.), and National Centre for Register-Based Research (J.C., J.W.D., Y.S.), Aarhus University, Denmark; Core Facility for Biostatistics and Data Analysis (J.I.), Department of Global Public Health and Primary Care, University of Bergen, Norway; Department of Knowledge Brokers (M.K.L., M.G.), Finnish Institute for Health and Welfare (THL), Helsinki, Finland; Departments of Molecular Medicine and Surgery (M.G.), Clinical Neuroscience (T.T.), and Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden
| | - Mika Gissler
- From the Department of Clinical Medicine (S.A., E.S.N.H., J.W.D., N.E.G., M.B.), University of Bergen; National Center for Epilepsy (S.A.), Oslo; Department of Neurology (E.S.N.H., N.E.G., M.B.), Haukeland University Hospital, Bergen, Norway; Department of Neurology (J.C., Y.S.), and National Centre for Register-Based Research (J.C., J.W.D., Y.S.), Aarhus University, Denmark; Core Facility for Biostatistics and Data Analysis (J.I.), Department of Global Public Health and Primary Care, University of Bergen, Norway; Department of Knowledge Brokers (M.K.L., M.G.), Finnish Institute for Health and Welfare (THL), Helsinki, Finland; Departments of Molecular Medicine and Surgery (M.G.), Clinical Neuroscience (T.T.), and Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden
| | - Nils Erik Gilhus
- From the Department of Clinical Medicine (S.A., E.S.N.H., J.W.D., N.E.G., M.B.), University of Bergen; National Center for Epilepsy (S.A.), Oslo; Department of Neurology (E.S.N.H., N.E.G., M.B.), Haukeland University Hospital, Bergen, Norway; Department of Neurology (J.C., Y.S.), and National Centre for Register-Based Research (J.C., J.W.D., Y.S.), Aarhus University, Denmark; Core Facility for Biostatistics and Data Analysis (J.I.), Department of Global Public Health and Primary Care, University of Bergen, Norway; Department of Knowledge Brokers (M.K.L., M.G.), Finnish Institute for Health and Welfare (THL), Helsinki, Finland; Departments of Molecular Medicine and Surgery (M.G.), Clinical Neuroscience (T.T.), and Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden
| | - Torbjörn Tomson
- From the Department of Clinical Medicine (S.A., E.S.N.H., J.W.D., N.E.G., M.B.), University of Bergen; National Center for Epilepsy (S.A.), Oslo; Department of Neurology (E.S.N.H., N.E.G., M.B.), Haukeland University Hospital, Bergen, Norway; Department of Neurology (J.C., Y.S.), and National Centre for Register-Based Research (J.C., J.W.D., Y.S.), Aarhus University, Denmark; Core Facility for Biostatistics and Data Analysis (J.I.), Department of Global Public Health and Primary Care, University of Bergen, Norway; Department of Knowledge Brokers (M.K.L., M.G.), Finnish Institute for Health and Welfare (THL), Helsinki, Finland; Departments of Molecular Medicine and Surgery (M.G.), Clinical Neuroscience (T.T.), and Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden
| | - Marte Bjørk
- From the Department of Clinical Medicine (S.A., E.S.N.H., J.W.D., N.E.G., M.B.), University of Bergen; National Center for Epilepsy (S.A.), Oslo; Department of Neurology (E.S.N.H., N.E.G., M.B.), Haukeland University Hospital, Bergen, Norway; Department of Neurology (J.C., Y.S.), and National Centre for Register-Based Research (J.C., J.W.D., Y.S.), Aarhus University, Denmark; Core Facility for Biostatistics and Data Analysis (J.I.), Department of Global Public Health and Primary Care, University of Bergen, Norway; Department of Knowledge Brokers (M.K.L., M.G.), Finnish Institute for Health and Welfare (THL), Helsinki, Finland; Departments of Molecular Medicine and Surgery (M.G.), Clinical Neuroscience (T.T.), and Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden
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Ono T, Hino K, Kimura T, Uchimura Y, Ashihara T, Higa T, Kojima H, Murakami T, Udagawa J. Excessive folic acid intake combined with undernutrition during gestation alters offspring behavior and brain monoamine profiles. Congenit Anom (Kyoto) 2022; 62:169-180. [PMID: 35531602 DOI: 10.1111/cga.12472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 02/17/2022] [Accepted: 03/20/2022] [Indexed: 11/27/2022]
Abstract
Dietary folic acid augmentation during gestation reduces neurodevelopmental disorder risk in offspring; however, it is still unclear if excessive maternal folic acid intake can impair brain function in offspring. We examined if excessive folic acid intake throughout gestation altered the behavior of male offspring under poor nutrition during early gestation (E5.5-E11.5). Dams were divided into four groups: control (CON, 2 mg folic acid/kg of food), excessive folic acid fortification (FF, 10 mg folic acid/kg of food), undernutrition (UN, 40% food reduction from E5.5-E11.5), and excessive folic acid fortification plus undernutrition (UN-FF). Excess maternal folic acid fortification induced hyperactivity in the open-field and lower anxiety-like behavior in the elevated plus maze at 9 weeks of age. These behavioral changes were accompanied by reduced dopamine in the prefrontal cortex (PFC), norepinephrine in the amygdala, and 5-hydroxytryptamine (5-HT) in the dorsal midbrain (DM), PFC, and amygdala where 5-HT neurons project from the DM. Furthermore, canonical discriminant analysis, including dopamine and DOPAC concentrations in the PFC, norepinephrine concentrations in the PFC, amygdala, and pons, and 5-HT and 5-HIAA concentrations in the amygdala and DM, correctly classified 73.5% of the offspring in CON, FF, UN, and UN-FF groups. The first discriminant function mainly classified groups based on nutritional status, whereas the second function mainly classified groups based on folic acid intake. Our study suggests that combined transformations of brain monoamine profiles by maternal undernutrition and excess folic acid intake is involved in the behavioral alteration of offsprings.
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Affiliation(s)
- Tetsuo Ono
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu, Shiga, Japan.,Omihachiman Community Medical Center, Omihachiman, Shiga, Japan
| | - Kodai Hino
- Department of Anatomy, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Tomoko Kimura
- Department of Anatomy, Shiga University of Medical Science, Otsu, Shiga, Japan.,Department of Physical Therapy, Kyoto Tachibana University, Yamashina-ku, Kyoto, Japan
| | - Yasuhiro Uchimura
- Department of Anatomy, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Takashi Ashihara
- Department of Medical Informatics and Biomedical Engineering, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Takako Higa
- Department of Anatomy, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Hideto Kojima
- Department of Stem Cell Biology and Regenerative Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Takashi Murakami
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Jun Udagawa
- Department of Anatomy, Shiga University of Medical Science, Otsu, Shiga, Japan
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20
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Amada N, Kakumoto Y, Futamura T, Maeda K. Prenatal methotrexate injection increases behaviors possibly associated with depression and/or autism in rat offspring; A new animal model for mental disorder, based on folate metabolism deficit during pregnancy. Neuropsychopharmacol Rep 2022; 42:263-271. [PMID: 35502620 PMCID: PMC9515720 DOI: 10.1002/npr2.12255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/18/2022] [Accepted: 04/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background Deficiency of folate, an essential vitamin for DNA synthesis and methylation, is reported as a risk factor for mental disorders. Considering a possibility that folate metabolism deficit during pregnancy may disturb CNS development and increase mental disorders in offspring, we treated pregnant rats with methotrexate (MTX), an inhibitor of folate metabolic enzyme, and evaluated offspring behaviors. Methods Saline or MTX was intraperitoneally administered to female SD rats on gestational day 17. Offspring behaviors were evaluated during approximately 6–9 weeks old; prepulse inhibition (PPI), social interaction (SI), locomotor activity (LA), and forced swimming test (FST) for evaluation of schizophrenia, depression, and autism related behaviors; the elevated plus maze (EPM) and the light–dark box (LD) test for evaluation of anxiety. Results Compared to saline‐treated group, MTX‐treated group showed decrease of SI and increase of immobility time in FST. In addition, increases of time spent in the light box and shuttling between the light–dark boxes were observed in LD test. On the other hand, no changes were confirmed in EPM, LA, and PPI. Conclusion Decrease of SI and increase of immobility time in FST may suggest association of this animal model with depression and/or autism. Increase of time spent in the light box and shuttling between the light–dark boxes may indicate changes in anxiety or cognitive level to environment, or repetitive behaviors in autism. Although further studies are warranted to characterize this animal model, at least we can say that prenatal MTX exposure, possibly causing folate metabolism deficit, affects offspring behaviors.
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Affiliation(s)
- Naoki Amada
- Department of CNS Research, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan
| | - Yusuke Kakumoto
- Department of Lead Discovery Research, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan
| | - Takashi Futamura
- Department of CNS Research, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan
| | - Kenji Maeda
- Department of Lead Discovery Research, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan
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21
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Mills JL, Molloy AM. Lowering the risk of autism spectrum disorder with folic acid: can there be too much of a good thing? Am J Clin Nutr 2022; 115:1268-1269. [PMID: 35348591 PMCID: PMC9071475 DOI: 10.1093/ajcn/nqac048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Anne M Molloy
- Department of Clinical Medicine, School of Medicine, Trinity
College, Dublin, Ireland
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22
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Rahat B, Hamid A, Bagga R, Kaur J. Folic Acid Levels During Pregnancy Regulate Trophoblast Invasive Behavior and the Possible Development of Preeclampsia. Front Nutr 2022; 9:847136. [PMID: 35578613 PMCID: PMC9106796 DOI: 10.3389/fnut.2022.847136] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 03/18/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundOne of the unique features of placentation is its similarity to tumorigenesis yet being very well regulated. It allows rapid proliferation, migration, and invasion of mononuclear trophoblast cells into the maternal uterus and remodeling the maternal vasculature. This pseudomalignant nature of trophoblastic cells is strictly regulated and its importance becomes evident in abnormal pregnancies that are characterized by aberrant trophoblast proliferation/invasion like preeclampsia. In addition to this, the importance of folic acid supplementation during pregnancy is well documented. We aimed to analyze the molecular and epigenetic regulation of the pseudomalignant nature of placentation via folic acid levels.MethodsPlacental tissue samples were collected from different pregnancies in three different gestational stages. We estimated the impact of folic acid levels on global methylation, LINE1 methylation, and expression of DNMTs in all three gestational stages in pregnant women and preeclampsia pregnancies. We also analyzed the effect of folic acid supplementation on trophoblastic invasion using placental derived cells viz, JEG-3 and HTR-8/SVneo cell line and verified the molecular and epigenetic mechanisms involved in this regulation.ResultsDevelopment of preeclampsia was observed to be associated with lower folate levels in placental tissue, higher global methylation level, and higher expression of DNMT1and DNMT3A. Folic acid supplementation was found to increase the invasive potential of placental trophoblasts by almost two folds which were associated with the decreased expression of tumor suppressor genes and tissue inhibitors of matrix metalloproteinases; and increased expression of oncogenes, telomerase gene, and matrix metalloproteinases. These folic acid-mediated changes were observed to be regulated by CpG methylation in the case of many genes. Folic acid supplementation was also observed to significantly decrease global methylation in placental trophoblasts related to decreasing expression of DNMT1 and DNMT3A.ConclusionLower folic acid levels are associated with preeclampsia development and folic acid supplementation regulates the invasive potential of placental trophoblasts as mediated by various epigenetic changes in the placenta suggesting the protective effect of folic acid against preeclampsia.
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Affiliation(s)
- Beenish Rahat
- Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Abid Hamid
- Cancer Pharmacology Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India
| | - Rashmi Bagga
- Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jyotdeep Kaur
- Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
- *Correspondence: Jyotdeep Kaur
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23
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Hisada A, Takatani R, Yamamoto M, Nakaoka H, Sakurai K, Mori C. Maternal Iodine Intake and Neurodevelopment of Offspring: The Japan Environment and Children's Study. Nutrients 2022; 14:nu14091826. [PMID: 35565793 PMCID: PMC9105063 DOI: 10.3390/nu14091826] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/20/2022] [Accepted: 04/24/2022] [Indexed: 02/05/2023] Open
Abstract
Inadequate maternal iodine intake affects thyroid function and may impair fetal brain development. This study investigated the association between maternal iodine intake during pregnancy and neurodevelopmental delay in offspring at 1 and 3 years of age using a nationwide birth cohort: the Japan Environment and Children’s Study. We assessed dietary iodine intake during pregnancy using a food frequency questionnaire and child neurodevelopment using the Japanese translation of the Ages and Stages Questionnaire, Third Edition. The risk of delay (score below the cut-off value) for fine motor domain at 1 year of age was increased in the lowest quintile iodine intake group compared with the fourth quintile iodine intake group. The risk of delay for problem-solving at 1 year of age was increased in the lowest and second quintile iodine intake group and decreased in the highest quintile iodine intake group. The risk of delay for communication, fine motor, problem-solving, and personal–social domains at 3 years of age was increased in the lowest and second quintile iodine intake group compared with the fourth quintile iodine intake group, while the risk of delay for fine motor and problem-solving domains was decreased in the highest quintile iodine intake group. Low iodine intake levels in pregnancy may affect child neurodevelopment.
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Affiliation(s)
- Aya Hisada
- Center for Preventive Medical Sciences, Chiba University, 1–33 Yayoi-cho, Inage-ku, Chiba 263-8522, Japan; (R.T.); (M.Y.); (H.N.); (K.S.); (C.M.)
- Correspondence: ; Tel.: +81-4-3290-3896
| | - Rieko Takatani
- Center for Preventive Medical Sciences, Chiba University, 1–33 Yayoi-cho, Inage-ku, Chiba 263-8522, Japan; (R.T.); (M.Y.); (H.N.); (K.S.); (C.M.)
| | - Midori Yamamoto
- Center for Preventive Medical Sciences, Chiba University, 1–33 Yayoi-cho, Inage-ku, Chiba 263-8522, Japan; (R.T.); (M.Y.); (H.N.); (K.S.); (C.M.)
| | - Hiroko Nakaoka
- Center for Preventive Medical Sciences, Chiba University, 1–33 Yayoi-cho, Inage-ku, Chiba 263-8522, Japan; (R.T.); (M.Y.); (H.N.); (K.S.); (C.M.)
| | - Kenichi Sakurai
- Center for Preventive Medical Sciences, Chiba University, 1–33 Yayoi-cho, Inage-ku, Chiba 263-8522, Japan; (R.T.); (M.Y.); (H.N.); (K.S.); (C.M.)
| | - Chisato Mori
- Center for Preventive Medical Sciences, Chiba University, 1–33 Yayoi-cho, Inage-ku, Chiba 263-8522, Japan; (R.T.); (M.Y.); (H.N.); (K.S.); (C.M.)
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
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Nakahara K, Michikawa T, Morokuma S, Hamada N, Ogawa M, Kato K, Sanefuji M, Shibata E, Tsuji M, Shimono M, Kawamoto T, Ohga S, Kusuhara K. Association of maternal hemoglobin levels during pregnancy with sleep and developmental problems in 1-year-old infants: A cohort study. Health Sci Rep 2022; 5:e552. [PMID: 35308415 PMCID: PMC8907744 DOI: 10.1002/hsr2.552] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/28/2021] [Accepted: 01/06/2022] [Indexed: 11/11/2022] Open
Abstract
Background and Aims Maternal hemoglobin concentration during pregnancy is reported to be associated with various perinatal outcomes and may also be associated with infant development. This study aims to investigate the association between maternal hemoglobin levels during early or mid-pregnancy and sleep and developmental problems in 1-year-old infants. Methods We used the data of 66,935 pregnant women who were participants of the Japan Environment and Children's Study, a nationwide cohort study in Japan, between 2011 and 2014. Maternal hemoglobin level was examined at recruitment (mean gestational age, 15.3 weeks; SD, 2.85 weeks; range, 6-22 weeks). Information on infant sleep and development at the age of 1 year was acquired using a questionnaire. Infant development was evaluated using the Ages and Stages Questionnaire (ASQ). Results The mean (SD) maternal hemoglobin level was 12.0 (1.0) g/dl. Maternal hemoglobin levels were not associated with the majority of infant sleep and developmental outcomes. In the group with maternal hemoglobin <10.0 g/dl, the risk ratio (RR) for sleep at 22:00 or later was higher than that in the reference group with 11.0 g/dl ≤ hemoglobin < 14.0 g/dl (RR 1.12, 95% confidence interval = 1.00-1.25). In the analysis with maternal hemoglobin level as a continuous variable, both high and low hemoglobin levels were associated with a higher RR of a late bedtime. In addition, a low maternal hemoglobin level was associated with a higher RR for abnormal fine motor skills in the ASQ. Conclusion Our results suggest that a low level of maternal hemoglobin during pregnancy is associated with late bedtime and abnormal fine motor skills in 1-year-old infants. Conversely, a high level of maternal hemoglobin may also be associated with the infant's late bedtime.
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Affiliation(s)
- Kazushige Nakahara
- Department of Obstetrics and Gynecology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Takehiro Michikawa
- Department of Environmental and Occupational Health, School of MedicineToho UniversityTokyoJapan
| | - Seiichi Morokuma
- Department of Health Sciences, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Research Centre for Environment and Developmental Medical SciencesKyushu UniversityFukuokaJapan
| | - Norio Hamada
- Department of Obstetrics and Gynecology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Research Centre for Environment and Developmental Medical SciencesKyushu UniversityFukuokaJapan
| | - Masanobu Ogawa
- Department of Obstetrics and Gynecology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Research Centre for Environment and Developmental Medical SciencesKyushu UniversityFukuokaJapan
| | - Kiyoko Kato
- Department of Obstetrics and Gynecology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Research Centre for Environment and Developmental Medical SciencesKyushu UniversityFukuokaJapan
| | - Masafumi Sanefuji
- Research Centre for Environment and Developmental Medical SciencesKyushu UniversityFukuokaJapan
- Department of Pediatrics, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Eiji Shibata
- Japan Environment and Children's Study, UOEH Subunit CentreUniversity of Occupational and Environmental HealthKitakyushuJapan
- Department of Obstetrics and Gynecology, School of MedicineUniversity of Occupational and Environmental HealthKitakyushuJapan
| | - Mayumi Tsuji
- Japan Environment and Children's Study, UOEH Subunit CentreUniversity of Occupational and Environmental HealthKitakyushuJapan
- Department of Environmental Health, School of MedicineUniversity of Occupational and Environmental HealthKitakyushuJapan
| | - Masayuki Shimono
- Japan Environment and Children's Study, UOEH Subunit CentreUniversity of Occupational and Environmental HealthKitakyushuJapan
- Department of PediatricsUniversity of Occupational and Environmental HealthKitakyushuJapan
| | - Toshihiro Kawamoto
- Japan Environment and Children's Study, UOEH Subunit CentreUniversity of Occupational and Environmental HealthKitakyushuJapan
| | - Shouichi Ohga
- Research Centre for Environment and Developmental Medical SciencesKyushu UniversityFukuokaJapan
- Department of Pediatrics, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Koichi Kusuhara
- Japan Environment and Children's Study, UOEH Subunit CentreUniversity of Occupational and Environmental HealthKitakyushuJapan
- Department of PediatricsUniversity of Occupational and Environmental HealthKitakyushuJapan
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Gama MI, Pinto A, Daly A, Rocha JC, MacDonald A. The Impact of the Quality of Nutrition and Lifestyle in the Reproductive Years of Women with PKU on the Long-Term Health of Their Children. Nutrients 2022; 14:nu14051021. [PMID: 35267995 PMCID: PMC8912747 DOI: 10.3390/nu14051021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/24/2022] [Accepted: 02/24/2022] [Indexed: 11/29/2022] Open
Abstract
A woman’s nutritional status before and during pregnancy can affect the health of her progeny. Phenylketonuria (PKU), a rare disorder causing high blood and brain phenylalanine (Phe) concentrations, is associated with neurocognitive disability. Lifelong treatment is mainly dietetic with a Phe-restricted diet, supplemented with a low-Phe protein substitute. Treatment adherence commonly decreases in adolescence, with some adults ceasing dietary treatment. In maternal PKU, elevated blood Phe is harmful to the fetus so a strict Phe-restricted diet must be re-established preconception, and this is particularly difficult to achieve. A woman’s reproductive years introduces an opportunity to adopt healthier behaviours to prepare for successful pregnancies and positive health outcomes for both themselves and their children. Several factors can influence the health status of women with PKU. Political, socioeconomic, and individual food and lifestyle choices affect diet quality, metabolic control, and epigenetics, which then pre-condition the overall maternal health and long-term health of the child. Here, we reflect on a comprehensive approach to treatment and introduce practical recommendations to optimize the wellbeing of women with PKU and the resultant health of their children.
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Affiliation(s)
- Maria Inês Gama
- Nutrition & Metabolism, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (M.I.G.); (J.C.R.)
| | - Alex Pinto
- Birmingham Women’s and Children’s Hospital, Birmingham B4 6NH, UK; (A.P.); (A.D.)
| | - Anne Daly
- Birmingham Women’s and Children’s Hospital, Birmingham B4 6NH, UK; (A.P.); (A.D.)
| | - Júlio César Rocha
- Nutrition & Metabolism, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (M.I.G.); (J.C.R.)
- Reference Centre of Inherited Metabolic Diseases, Centro Hospitalar Universitário de Lisboa Central, 1169-045 Lisboa, Portugal
- CINTESIS—Center for Health Technology and Services Research, NOVA Medical School, Campo dos Mártires da Pátria 130, 1169-056 Lisboa, Portugal
| | - Anita MacDonald
- Birmingham Women’s and Children’s Hospital, Birmingham B4 6NH, UK; (A.P.); (A.D.)
- Correspondence:
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26
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Kok DE, Richmond RC, Adriaens M, Evelo CT, Ford D, Mathers JC, Robinson N, McKay JA. Impact of In Utero Folate Exposure on DNA Methylation and Its Potential Relevance for Later-Life Health-Evidence from Mouse Models Translated to Human Cohorts. Mol Nutr Food Res 2022; 66:e2100789. [PMID: 34850562 PMCID: PMC7614326 DOI: 10.1002/mnfr.202100789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/29/2021] [Indexed: 11/08/2022]
Abstract
SCOPE Persistent DNA methylation changes may mediate effects of early-life exposures on later-life health. Human lifespan is challenging for prospective studies, therefore data from longitudinal studies are limited. Projecting data from mouse models of early-life exposure to human studies offers a tool to address this challenge. METHODS AND RESULTS C57BL/6J mice were fed low/normal folate diets before and during pregnancy and lactation. Genome-wide promoter methylation was measured in male offspring livers at 17.5 days gestation and 28 weeks. Eight promoters were concurrently hypermethylated by folate depletion in fetuses and adults (>1.10 fold-change; p < 0.05). Processes/pathways potentially influenced by global changes, and function of these eight genes, suggest neurocognitive effects. Human observational and randomized controlled trial data were interrogated for translation. Methylation at birth was inversely associated with maternal plasma folate in six genes (-1.15% to -0.16% per nmol L-1 ; p < 0.05), while maternal folic acid supplementation was associated with differential methylation of four genes in adulthood. Three CpGs were persistently hypermethylated with lower maternal folate (p = 0.04). CONCLUSION Some persistent folate-induced methylation changes in mice are mirrored in humans. This demonstrates utility of mouse data in identifying human loci for interrogation as biomarkers of later-life health.
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Affiliation(s)
- Dieuwertje E Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Rebecca C Richmond
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Michiel Adriaens
- Maastricht Centre for Systems Biology, Maastricht University, Maastricht, The Netherlands
| | - Chris T Evelo
- Maastricht Centre for Systems Biology, Maastricht University, Maastricht, The Netherlands.,Department of Bioinformatics - BiGCaT, NUTRIM Research School, Maastricht University, Maastricht, The Netherlands
| | - Dianne Ford
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - John C Mathers
- Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Human Nutrition Research Centre, Newcastle upon Tyne, UK
| | - Natassia Robinson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jill A McKay
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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Melfald Tveten K, Miodini Nilsen R, Dragesund T. Maternal Folic Acid-Containing Supplement Use in Relation to Offspring Motor Function. A Prospective Study of 503 Mother-Child Dyads. Front Pediatr 2022; 10:789158. [PMID: 35450102 PMCID: PMC9016160 DOI: 10.3389/fped.2022.789158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 03/15/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The preventive effect of maternal folic acid use on offspring neural tube defects is well-established. However, a putative link between supplement use and other neurodevelopmental outcome is inconsistent. The aim of this study was to examine the association of folic acid-containing supplement use before and during pregnancy with motor function in children aged 3-18 months. METHOD The study has a prospective cohort design including 503 mother-infant dyads. Motor function was measured by the Infant Motor Profile (IMP) and Ages and Stages Questionnaire Second Edition (ASQ-2). Associations between exposure and outcome were examined using linear regression analysis with robust standard error estimation. RESULTS Offspring total IMP score was not associated with any maternal folic acid-containing supplement use when they were used during pregnancy only (adjusted β = 0.11 95% CI = -1.19, 1.40; p = 0.87) or when they were used both before and during pregnancy (adjusted β = 0.22 95% CI = -0.95, 1.40; p = 0.70). When examining the five domain scores separately, only the IMP domain adaptability showed some association with supplement use during pregnancy (adjusted β = 2.87; 95% CI = 0.08, 5.68; p = 0.04), but the strength of the association was weak. Further, supplement use was not associated with any of the two motor domains of ASQ-2. CONCLUSION Although no association between folic acid-containing supplement use and offspring motor function was found, the complexity of this topic and its potential mechanisms, requires further investigation. This research should include robust and accurate measures on maternal nutritional status along with thorough endpoint assessments.
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Affiliation(s)
- Kine Melfald Tveten
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Roy Miodini Nilsen
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Tove Dragesund
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
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Managing folate deficiency implies filling the gap between laboratory and clinical assessment. Clin Nutr 2021; 41:374-383. [PMID: 34999332 DOI: 10.1016/j.clnu.2021.12.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/02/2021] [Accepted: 12/07/2021] [Indexed: 11/22/2022]
Abstract
The characterization of folate status in subjects at risk of deficiency and with altered vitamin homeostasis is crucial to endorse preventive intervention health policies, especially in developed countries. Several physiological changes (i.e. pregnancy), clinical situations and diseases have been associated to increased requirement, impaired intake and absorption of folate. However clinical practice guidelines (CPG) endorse folic acid supplementation generally discarding the use of its determination in serum to assess the risk of deficiency and/or its concentration at baseline. Poor confidence on the diagnostic accuracy of serum folate assays still persists in the current CPGs although recent standardization efforts have greatly improved inter-method variability and precision. In this review we critically appraise the methodological issues concerning laboratory folate determination and the evidence on the potential adverse effects of folic acid exposure. The final aim is to build a sound background to promote serum folate-based cost-effective health care policies by optimizing folic acid supplementation in subjects at risk of deficiency and with altered folate homeostasis. Our first result was to adjust in relation to current serum folate assays the thresholds reported by CPGs as index of folate status, defined on the association with metabolic and hematologic indicators. We identify a statistically significant difference between the estimated thresholds and accordingly show that the assessment of folate status actually changes in relation to the assay employed. The use of the method-dependent thresholds here reported may pragmatically endorse the stewardship of folic acid supplementation in clinical practice and increase the cost-effectiveness of health care policies.
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Husen SC, Kemper ND, Go AT, Willemsen SP, Rousian M, Steegers-Theunissen RP. Periconceptional maternal folate status and the impact on embryonic head and brain structures: the Rotterdam Periconceptional Cohort. Reprod Biomed Online 2021; 44:515-523. [DOI: 10.1016/j.rbmo.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 10/04/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022]
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30
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Chen H, Qin L, Gao R, Jin X, Cheng K, Zhang S, Hu X, Xu W, Wang H. Neurodevelopmental effects of maternal folic acid supplementation: a systematic review and meta-analysis. Crit Rev Food Sci Nutr 2021:1-17. [PMID: 34672229 DOI: 10.1080/10408398.2021.1993781] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Folic acid, a water-soluble vitamin B nutrient, plays an important role not only in maintaining a healthy pregnancy but also in offspring brain development and function, however, it remains unclear whether maternal folic acid (FA) supplementation associated with the risk of different postnatal neurodevelopmental outcomes. Here, we performed a systematic review and meta-analysis on the impact of maternal FA supplementation on a wide range of postnatal neurodevelopmental outcomes which include intellectual development, risk of autistic traits, ADHD, behavior, language, and psychomotor problems, using studies extracted from the following databases, including MEDLINE, Web of Science, Cochrane Library, Scopus, EMBASE, and PsychInfo. Thirty-two cohort studies and seven case-control studies were included in this meta-analysis. In the present study, we found that prenatal FA supplementation had a positive impact on offspring's neurodevelopmental outcomes, including improved intellectual development and reduced risk of autism traits, ADHD, behavioral, and language problems. We also found that FA over-supplementation was not associated with an improvement in offspring's brain development, and may have a negative impact on offspring's neurodevelopmental outcomes. This study proved the first panoramic review on the relationship of FA supplementation with offspring's neurodevelopment. Further studies focusing on different dosages and periods of FA supplementation are needed.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.1993781 .
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Affiliation(s)
- Hanxiao Chen
- Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Lang Qin
- Reproductive Centre, Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Rui Gao
- Reproductive Centre, Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Xiaolei Jin
- Reproductive Centre, Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Kemin Cheng
- Outpatient Department, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Sirui Zhang
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Xiao Hu
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Wenming Xu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.,SCU-CUHK Joint Laboratory for Reproductive Medicine, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Hongjing Wang
- Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
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31
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Müffelmann B, Hagemann A, Knaak N, Bien CG. [Women with epilepsy before and during pregnancy: a case series of outpatient counseling in a tertiary epilepsy center]. DER NERVENARZT 2021; 93:566-574. [PMID: 34608536 DOI: 10.1007/s00115-021-01198-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/27/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Data of large pregnancy registries have improved the recommendations for women with epilepsy before pregnancy. Monotherapy containing antiepileptic drugs with a low malformation rate (lamotrigine or levetiracetam) is recommended as well as preconceptional folic acid supplementation, while valproic acid should be avoided. The practicability of these recommendations remains controversial. METHODS Retrospective case series of 160 women with epilepsy over a period of 5 years who were advised in our outpatient department before and during pregnancy. RESULTS Only 18.9% of women presented with valproic acid. Even without valproic acid, complications or emergency admissions rarely occurred under specialist supervision. In our case series, lamotrigine proved to be less effective and less controllable than other drugs during pregnancy. Levetiracetam also has a low malformation rate, but showed a better effect on seizure outcome during pregnancy than lamotrigine. Only 12% of women who wanted to have children took folic acid. CONCLUSION This case series comes from a tertiary center; the referred women were mainly accompanied by neurologists with special expertise in epileptology. In this group valproate could be avoided in most cases. Lamotrigine is probably less effective due to the drop in blood levels during pregnancy. Levetiracetam seems to be a good alternative, working well against focal and generalized seizures. Folic acid may be taken later than recommended.
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Affiliation(s)
- Birgitt Müffelmann
- Krankenhaus Mara, Epilepsie-Zentrum Bethel, Universitätsklinik für Epileptologie, Maraweg 17-21, 33617, Bielefeld, Deutschland.
| | - Anne Hagemann
- Epilepsie-Zentrum Bethel, Gesellschaft für Epilepsieforschung, Bielefeld, Deutschland
| | - Niklas Knaak
- Campus Kiel, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland
| | - Christian G Bien
- Krankenhaus Mara, Epilepsie-Zentrum Bethel, Universitätsklinik für Epileptologie, Maraweg 17-21, 33617, Bielefeld, Deutschland
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Matsumura K, Hamazaki K, Tsuchida A, Inadera H. Prospective association of air purifier use during pregnancy with the neurodevelopment of toddlers in the Japan Environment and Children's Study. Sci Rep 2021; 11:19454. [PMID: 34593840 PMCID: PMC8484572 DOI: 10.1038/s41598-021-98482-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 09/09/2021] [Indexed: 01/23/2023] Open
Abstract
We examined the association between maternal air purifier use during pregnancy and neurodevelopmental delay in toddlers by analysing data from 82,457 mother-toddler pairs. Air purifier use was measured using a simple yes/no question. Developmental delays at 1.5, 2.0, 2.5, and 3.0 years were assessed using the Ages and Stages Questionnaire, Third Edition. Generalized additive mixed model analysis with 21 covariates revealed that air purifier use was associated with lower prevalence of developmental delay in all five areas—communication, gross motor, fine motor, problem solving, and personal-social—at all four time points (adjusted risk ratios ranged from 0.827 to 0.927, and only one 95% confidence interval crossed the reference). These findings suggest a negative association between air purifier use during pregnancy and neurodevelopmental delay in toddlers. Trial registration: UMIN000030786 (15/01/2018).
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Affiliation(s)
- Kenta Matsumura
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan. .,Toyama Regional Center for JECS, University of Toyama, Toyama, Japan.
| | - Kei Hamazaki
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.,Toyama Regional Center for JECS, University of Toyama, Toyama, Japan.,Department of Public Health, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Akiko Tsuchida
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.,Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Hidekuni Inadera
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.,Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
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Apte A, Kapoor M, Naik S, Lubree H, Khamkar P, Singh D, Agarwal D, Roy S, Kawade A, Juvekar S, Banerjee R, Bavdekar A. Efficacy of transdermal delivery of liposomal micronutrients through body oil massage on neurodevelopmental and micronutrient deficiency status in infants: results of a randomized placebo-controlled clinical trial. BMC Nutr 2021; 7:48. [PMID: 34493339 PMCID: PMC8524365 DOI: 10.1186/s40795-021-00458-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Micronutrient deficiency is a known cause of adverse neurodevelopment and growth. Poor adherence to oral regimes of micronutrient supplements is a known challenge during the implementation of supplementation programs. The present study evaluates the benefits of liposomal encapsulated micronutrient fortified body oils (LMF oil) that can be used for infant body massage in terms of neurodevelopment and prevention of deficiency. STUDY DESIGN Double-blind randomized clinical trial. METHODS A total of 444 healthy infants aged 4-7 weeks were randomized to receive either LMF oil (containing iron, vitamin D, folate, and vitamin B12) or placebo oil for gentle body massage till 12 months of age. Blood samples were collected at 6 and 12 months for transferrin saturation (TSAT), hemoglobin, and 25-hydroxy vitamin (25-OH-D) levels. Mental and motor development was assessed at 12 months using developmental assessment for Indian Infants (DASII). RESULTS A total of 391 infants completed the study. There was no significant improvement in the hemoglobin in the intervention group at 12 months of age as compared to the placebo group [- 0.50 vs.-0.54 g%]. There was a marginally significant improvement in 25-OH-D at 12 months in the LMF oil group [+ 1.46vs.-0.18 ng/ml, p = 0.049]. In the subgroup of infants with moderate anemia, the intervention prevented the decline in hemoglobin at 12 months of age [adjusted mean change + 0.11vs.-0.51 g%, p = 0.043]. The mental or motor developmental quotients in the intervention group were not significantly different from those in the placebo group. CONCLUSION Use of LMF oil for prevention of nutritional deficiency did not offer significant protection against nutritional anemia but prevented vitamin D deficiency to some extent with improvement in 25-OH-D at 12 months. In the subgroup of infants with moderate anemia, the intervention prevented the decline in hemoglobin at 12 months of age. The intervention did not result in significant improvement in mental or motor development. Further evaluation with increased doses needs to be undertaken. TRIAL REGISTRATION CTRI no: CTRI/2017/11/010710 ; dated 30/11/2017.
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Affiliation(s)
- Aditi Apte
- Department of Biosciences and Bioengineering, Nanomedicine Laboratory, Indian Institute of Technology Bombay, Powai, Mumbai, India. .,PRERNA Young Scientist, KEM Hospital Research Centre, Pune, India.
| | - Mudra Kapoor
- Department of Biosciences and Bioengineering, Nanomedicine Laboratory, Indian Institute of Technology Bombay, Powai, Mumbai, India
| | | | - Himangi Lubree
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Pooja Khamkar
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Diksha Singh
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Dhiraj Agarwal
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Sudipto Roy
- PRERNA Young Scientist, KEM Hospital Research Centre, Pune, India
| | - Anand Kawade
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Sanjay Juvekar
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Rinti Banerjee
- Department of Biosciences and Bioengineering, Nanomedicine Laboratory, Indian Institute of Technology Bombay, Powai, Mumbai, India
| | - Ashish Bavdekar
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
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Hoxha B, Hoxha M, Domi E, Gervasoni J, Persichilli S, Malaj V, Zappacosta B. Folic Acid and Autism: A Systematic Review of the Current State of Knowledge. Cells 2021; 10:cells10081976. [PMID: 34440744 PMCID: PMC8394938 DOI: 10.3390/cells10081976] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/04/2021] [Accepted: 07/27/2021] [Indexed: 12/30/2022] Open
Abstract
Folic acid has been identified to be integral in rapid tissue growth and cell division during fetal development. Different studies indicate folic acid’s importance in improving childhood behavioral outcomes and underline its role as a modifiable risk factor for autism spectrum disorders. The aim of this systematic review is to both elucidate the potential role of folic acid in autism spectrum disorders and to investigate the mechanisms involved. Studies have pointed out a potential beneficial effect of prenatal folic acid maternal supplementation (600 µg) on the risk of autism spectrum disorder onset, but opposite results have been reported as well. Folic acid and/or folinic acid supplementation in autism spectrum disorder diagnosed children has led to improvements, both in some neurologic and behavioral symptoms and in the concentration of one-carbon metabolites. Several authors report an increased frequency of serum auto-antibodies against folate receptor alpha (FRAA) in autism spectrum disorder children. Furthermore, methylene tetrahydrofolate reductase (MTHFR) polymorphisms showed a significant influence on ASD risk. More clinical trials, with a clear study design, with larger sample sizes and longer observation periods are necessary to be carried out to better evaluate the potential protective role of folic acid in autism spectrum disorder risk.
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Affiliation(s)
- Bianka Hoxha
- Department of Chemical-Pharmaceutical and Biomolecular Technologies, Faculty of Pharmacy, Catholic University “Our Lady of Good Counsel”, Rruga Dritan Hoxha, 1000 Tirana, Albania;
| | - Malvina Hoxha
- Department for Chemical-Toxicological and Pharmacological Evaluation of Drugs, Faculty of Pharmacy, Catholic University “Our Lady of Good Counsel”, Rruga Dritan Hoxha, 1000 Tirana, Albania; (E.D.); (B.Z.)
- Correspondence: ; Tel.: +355-42-273-290
| | - Elisa Domi
- Department for Chemical-Toxicological and Pharmacological Evaluation of Drugs, Faculty of Pharmacy, Catholic University “Our Lady of Good Counsel”, Rruga Dritan Hoxha, 1000 Tirana, Albania; (E.D.); (B.Z.)
| | - Jacopo Gervasoni
- Area Diagnostica di Laboratorio UOC Chimica, Biochimica e Biologia Molecolare Clinica Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy; (J.G.); (S.P.)
| | - Silvia Persichilli
- Area Diagnostica di Laboratorio UOC Chimica, Biochimica e Biologia Molecolare Clinica Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy; (J.G.); (S.P.)
| | - Visar Malaj
- Department of Economics, Faculty of Economy, University of Tirana, 1000 Tirana, Albania;
| | - Bruno Zappacosta
- Department for Chemical-Toxicological and Pharmacological Evaluation of Drugs, Faculty of Pharmacy, Catholic University “Our Lady of Good Counsel”, Rruga Dritan Hoxha, 1000 Tirana, Albania; (E.D.); (B.Z.)
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Kandel P, Lim S, Pirotta S, Skouteris H, Moran LJ, Hill B. Enablers and barriers to women's lifestyle behavior change during the preconception period: A systematic review. Obes Rev 2021; 22:e13235. [PMID: 33754474 DOI: 10.1111/obr.13235] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 02/24/2021] [Indexed: 12/16/2022]
Abstract
Healthy lifestyle behaviors during the preconception period are important to optimize maternal and child outcomes, including weight. However, the majority of women do not have optimal preconception lifestyle behaviors. This systematic review explored enablers and barriers to women's preconception lifestyle behaviors using the Capability, Opportunity, Motivation, Behaviour (COM-B) model and Theoretical Domains Framework (TDF). Preconception was defined as the time before conception, capturing planned and unplanned pregnancies. Medline Complete, EMBASE, PsycINFO, and CINAHL were searched for peer-reviewed, quantitative and qualitative primary studies (English, 2006-2020) that explored enablers and barriers to lifestyle behaviors (diet, physical activity, smoking, alcohol use, supplement intake). Forty-two studies (of 3406) were included, assessing supplement use (n = 37), diet (n = 10), smoking (n = 10), alcohol use (n = 8), and physical activity (n = 5). All three COM-B components were identified only for diet and supplement use. Of the 14 TDF domains, 7 were identified: knowledge, beliefs about capabilities, beliefs about consequences, goals, intentions, social support, and environmental context and resources. The presence/absence of knowledge on healthy behaviors was the most commonly assessed enabler/barrier. Future studies should explore a wider range of factors influencing preconception women's capability, opportunity, and motivation to modify their lifestyle behaviors.
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Affiliation(s)
- Pragya Kandel
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Siew Lim
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Stephanie Pirotta
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.,Warwick Business School, University of Warwick, Coventry, UK
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Briony Hill
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
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Zhang L, Duan C, Guo Y, Zhang Y, Liu Y. Inhibition of prolactin promotes secondary skin follicle activation in cashmere goats. J Anim Sci 2021; 99:6167825. [PMID: 33693756 DOI: 10.1093/jas/skab079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/09/2021] [Indexed: 12/20/2022] Open
Abstract
The aim of this study was to investigate the involvement of prolactin (PRL) on development of secondary skin follicles in cashmere goats. Goats were randomly assigned to either a bromocriptine treatment or control group. Samples of cashmere fiber, blood, and skin were collected from all goats after 1 mo. The results indicated that the length, growth rate, and diameter of fibers were not influenced (P > 0.05) by the inhibition of PRL resulting from the treatment with bromocriptine. There was a tendency for increases in total follicle number, primary and secondary follicle numbers, and in the ratio of secondary to primary follicles following treatment with bromocriptine, but these differences were not significant (P > 0.05). The percentage of active secondary follicles in anagen was increased (P < 0.05) in the bromocriptine-treated goats, but there was no effect of treatment on the percentage of active primary follicles. Bromocriptine decreased (P < 0.05) circulating concentrations of PRL and Insulin-like growth factor 1 (IGF1) and increased (P < 0.05) those of melatonin (MT), but there was no effect of this treatment on the serum concentrations of cortisol, growth hormone, tetraiodothyronine, and triiodothyronine. In bromocriptine-treated goats, mRNA expressions of PRL and MT membrane receptor 1a (MTNR1a) were decreased (P < 0.05) and mRNA expression of MT nuclear receptor (RORα) was increased (P < 0.05), but there was no effect of the treatment on expression of long PRL receptor, short PRL receptor, MT membrane receptor 1b and IGF1. It is concluded that inhibition of PRL promotes secondary hair follicle development in the anagen phase, possibly by downregulating MTNR1a and up-regulating RORα gene expression in the skin.
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Affiliation(s)
- Lechao Zhang
- College of Animal Science and Technology, Hebei Agricultural University, Baoding 071000, PR China
| | - Chunhui Duan
- College of Animal Science and Technology, Hebei Agricultural University, Baoding 071000, PR China
| | - Yunxia Guo
- College of Life Science, Hebei Agricultural University, Baoding 071000, PR China
| | - Yingjie Zhang
- College of Animal Science and Technology, Hebei Agricultural University, Baoding 071000, PR China
| | - Yueqin Liu
- College of Animal Science and Technology, Hebei Agricultural University, Baoding 071000, PR China
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House Dust Avoidance during Pregnancy and Subsequent Infant Development: The Japan Environment and Children's Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084277. [PMID: 33920677 PMCID: PMC8073752 DOI: 10.3390/ijerph18084277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 01/10/2023]
Abstract
House dust, well known for causing allergy, contains chemicals that are harmful to fetal neurodevelopment. However, whether countermeasures for house dust allergy, such as frequent use of vacuum cleaners, frequent airing of futons, and the usage of anti-mite covers during pregnancy, are related to subsequent reduced risk of infant developmental delay remains unknown. Therefore, we examined this association by analyzing 81,106 mother-infant pairs who participated in a nationwide birth cohort in Japan. Infant developmental delays at 6 and 12 months postpartum were assessed using the Ages and Stages Questionnaire, Third Edition. A generalized linear model analysis was used to derive adjusted odds ratios (AORs) with the lowest care frequency as reference, while controlling 22 covariates. Our analysis showed that the above-mentioned cleaning measures were overall associated with a reduced risk of developmental delays, both at 6 and 12 months postpartum (AOR varied from 0.73 to 0.95, median: 0.84). Additionally, risks tended to decrease with an increase in the cleaning frequency. In conclusion, a negative dose-response association existed between these measures during pregnancy and infant developmental delay. Our results identify a potential role of frequent vacuum cleaning, airing bedding, and usage of anti-mite bedding covers in promoting intact infant development.
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Anitha A, Viswambharan V, Thanseem I, Iype M, Parakkal R, Surendran SP, Mundalil MV. Vitamins and Cognition: A Nutrigenomics Perspective. CURRENT NUTRITION & FOOD SCIENCE 2021. [DOI: 10.2174/1573401316999200901180443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The rise in the prevalence of neurodegenerative and neurodevelopmental cognitive disorders
combined with a lack of efficient therapeutic strategies has necessitated the need to develop alternate
approaches. Dietary supplements are now being considered as a complementary and alternative
medicine for cognitive impairments. Considerable evidence suggests the role of vitamins in
modulating the genetic and epigenetic factors implicated in neuropsychiatric, neurodevelopmental
and neurodegenerative disorders. In this review, we provide an overview of the implications of nutrigenomics
with reference to vitamins that are suggested to boost cognitive functions (nootropic vitamins).
Several vitamins have been found to possess antioxidant and anti-inflammatory properties
which make them potential candidates in preventing or delaying age-related neurodegeneration and
cognitive decline. Well-designed longitudinal studies are essential to examine the association between
vitamins and cognitive functions. Future studies linking nutrition with advances in neuroscience,
genomics and epigenomics would provide novel approaches to managing cognitive disorders.
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Affiliation(s)
- Ayyappan Anitha
- Department of Neurogenetics, Institute for Communicative and Cognitive Neurosciences (ICCONS), Shoranur, Palakkad 679 523, Kerala, India
| | - Vijitha Viswambharan
- Department of Neurogenetics, Institute for Communicative and Cognitive Neurosciences (ICCONS), Shoranur, Palakkad 679 523, Kerala, India
| | - Ismail Thanseem
- Department of Neurogenetics, Institute for Communicative and Cognitive Neurosciences (ICCONS), Shoranur, Palakkad 679 523, Kerala, India
| | - Mary Iype
- Government Medical College, Thiruvananthapuram 695 011, Kerala, India
| | - Rahna Parakkal
- Department of Neurogenetics, Institute for Communicative and Cognitive Neurosciences (ICCONS), Shoranur, Palakkad 679 523, Kerala, India
| | - Sumitha P. Surendran
- Department of Neurogenetics, Institute for Communicative and Cognitive Neurosciences (ICCONS), Shoranur, Palakkad 679 523, Kerala, India
| | - Mahesh V. Mundalil
- Department of Neurogenetics, Institute for Communicative and Cognitive Neurosciences (ICCONS), Shoranur, Palakkad 679 523, Kerala, India
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Ovung A, Bhattacharyya J. Sulfonamide drugs: structure, antibacterial property, toxicity, and biophysical interactions. Biophys Rev 2021; 13:259-272. [PMID: 33936318 PMCID: PMC8046889 DOI: 10.1007/s12551-021-00795-9] [Citation(s) in RCA: 126] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/03/2021] [Indexed: 12/11/2022] Open
Abstract
Sulfonamide (or sulphonamide) functional group chemistry (SN) forms the basis of several groups of drug. In vivo sulfonamides exhibit a range of pharmacological activities, such as anti-carbonic anhydrase and anti-t dihydropteroate synthetase allowing them to play a role in treating a diverse range of disease states such as diuresis, hypoglycemia, thyroiditis, inflammation, and glaucoma. Sulfamethazine (SMZ) is a commonly used sulphonamide drug in veterinary medicine that acts as an antibacterial compound to treat livestock diseases such as gastrointestinal and respiratory tract infections. Sulfadiazine (SDZ) is another frequently employed sulphonamide drug that is used in combination with the anti-malarial drug pyrimethamine to treat toxoplasmosis in warm-blooded animals. This study explores the research findings and the work behaviours of SN (SMZ and SDZ) drugs. The areas covered include SN drug structure, SN drug antibacterial activity, SN drug toxicity, and SN environmental toxicity.
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Affiliation(s)
- Aben Ovung
- Department of Chemistry, National Institute of Technology Nagaland, Chumukedima, Dimapur, 797103 India
| | - Jhimli Bhattacharyya
- Department of Chemistry, National Institute of Technology Nagaland, Chumukedima, Dimapur, 797103 India
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Wang S, Wei J, Wang D, Hua L, Pan D, Fu L, Yang J, Sun G. The association between folic acid supplementation, maternal folate during pregnancy and intelligence development in infants: a prospective cohort study. FOOD SCIENCE AND HUMAN WELLNESS 2021. [DOI: 10.1016/j.fshw.2021.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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ŞİMŞEK H, KARAAĞAÇ Y, TUNÇER E, YARDIMCI H. Gebelikte Folik Asit, B12 Vitamini, D Vitamini ve İyot Destekleri Kullanmak Gerekli Midir?: Olası Riskler. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2021. [DOI: 10.17517/ksutfd.832401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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The Use of Lower or Higher Than Recommended Doses of Folic Acid Supplements during Pregnancy Is Associated with Child Attentional Dysfunction at 4-5 Years of Age in the INMA Project. Nutrients 2021; 13:nu13020327. [PMID: 33498619 PMCID: PMC7912326 DOI: 10.3390/nu13020327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/15/2021] [Accepted: 01/19/2021] [Indexed: 12/13/2022] Open
Abstract
We assessed the association between the use of lower- and higher-than-recommended doses of folic acid supplements (FAs) during pregnancy and attentional function in boys and girls at age of 4–5. We analyzed data from 1329 mother-child pairs from the mother-child cohort INfancia y Medio Ambiente Project (INMA) study. Information on FAs use during pregnancy was collected in personal interviews at weeks 12 and 30, and categorized in <400, 400–999 (recommended dose), and ≥1000 μg/day. Child attentional function was assessed by Conners’ Kiddie Continuous Performance Test. Multivariable regression analyses were used to estimate incidence rate ratios (IRR) and beta coefficients with 95% confidence intervals (CI). Compared to recommended FAs doses, the periconceptional use of <400 and ≥1000 μg/day was associated with higher risk of omission errors—IRR = 1.14 (95% CI: 1.01; 1.29) and IRR = 1.16 (95% CI: 1.02; 1.33), respectively. The use of FAs < 400 μg/day and ≥1000 μg/day was significantly associated with deficits of attentional function only in boys. FAs use < 400 μg/day was associated with higher omission errors with IRR = 1.22 and increased hit reaction time (HRT) β = 34.36, and FAs use ≥ 1000 μg/day was associated with increased HRT β = 33.18 and HRT standard error β = 3.31. The periconceptional use of FAs below or above the recommended doses is associated with deficits of attentional function in children at age of 4–5, particularly in boys.
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Chen KY, Xu JX, Wang MM, Hu D, Xie F, Huang D, Chen J, Yang T, Zhang J, Song F, Huang S, Zhong T. Single probe PCR melting curve analysis MTHFR C677T SNP sites. Anal Biochem 2021; 619:114102. [PMID: 33450284 DOI: 10.1016/j.ab.2021.114102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND The detection and analysis of methylene tetrahydrofolate reductase (MTHFR) C677T single nucleotide polymorphism (SNP) from blood samples is time-consuming and costly. We aimed to establish a method to detect these SNPs by direct whole blood PCR and without DNA extraction. METHODS Probes modified by different fluorescent groups on the same sequence were designed. Various MTHFR genotypes from direct blood PCR experiments were used to verify the similarity of the obtained and sequencing results. The SNP sites adjacent to the MTHFR C677T SNP were used to verify whether the method can accurately distinguish these sites. RESULTS The ROX probe was found to be the most suitable for this study. We tested 291 samples with 1 μL whole blood as a template, and obtained 126, 43, and 122 cases of C677C, C677T, and C677 C/T genotypes, respectively. The melting curve was consistent with the sequencing results. The detection limit was approximately 1000 white blood cells/μL. Through PCR and the melting curve method, the adjacent sites were accurately distinguished. CONCLUSION We established a reliable, simple, rapid, and low-cost direct blood PCR method for the detection of MTHFR C677T SNPs. This could also be used as a potential diagnostic tool for a variety of diseases.
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Affiliation(s)
- Kai-Yun Chen
- Department of Drug Clinical Trial, The Fourth Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Jiang-Xia Xu
- Department of Laboratory Medicine, The Fourth Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Meng-Meng Wang
- Department of Pathology, The Fourth Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Die Hu
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, Jiangxi Province, China
| | - Fangfang Xie
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, Jiangxi Province, China
| | - Defa Huang
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, Jiangxi Province, China
| | - Jie Chen
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, Jiangxi Province, China
| | - Tong Yang
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, Jiangxi Province, China
| | | | | | | | - Tianyu Zhong
- Department of Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi Province, China.
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Wagner NR, MacDonald JL. Atypical Neocortical Development in the Cited2 Conditional Knockout Leads to Behavioral Deficits Associated with Neurodevelopmental Disorders. Neuroscience 2020; 455:65-78. [PMID: 33346116 DOI: 10.1016/j.neuroscience.2020.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/13/2020] [Accepted: 12/03/2020] [Indexed: 02/07/2023]
Abstract
The mammalian neocortex develops from a single layer of neuroepithelial cells to form a six-layer heterogeneous mosaic of differentiated neurons and glial cells. This process requires a complex choreography of temporally and spatially restricted transcription factors and epigenetic regulators. Even subtle disruptions in this regulation can alter the way the neocortex forms and functions, leading to a neurodevelopmental disorder. One epigenetic regulator that is essential for the precise development of the neocortex is CITED2 (CBP/p300 Interacting Transactivator with ED-rich termini). Cited2 is highly expressed by intermediate progenitor cells in the subventricular zone during the generation of the superficial layers of the neocortex. A forebrain-specific conditional knockout of Cited2 (cKO) exhibits reduced proliferation of intermediate progenitor cells embryonically, leading to reduced thickness of the superficial layers and reduced corpus callosum (CC) volume postnatally. Further, the Cited2 cKO display disruptions in balanced neocortical arealization, with a specific reduction in the somatosensory neocortical length, and dysregulation of precise, area-specific neuronal connectivity. Here, we explore the behavioral consequences resulting from this aberrant neocortical development. We demonstrate that Cited2 cKO mice display decreased maternal separation-induced ultrasonic vocalizations (USVs) as neonates, and an increase in rearing behavior and lack of habituation following repeated acoustic startle as adults. They do not display alterations in anxiety-like behavior, overall locomotor activity, or social interactions. Together with the morphological, molecular, and connectivity disruptions, these results identify the Cited2 cKO neocortex as an ideal system to study mechanisms underlying neurodevelopmental and neuroanatomical disruptions with relevance to human neurodevelopmental disorders.
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Affiliation(s)
- Nikolaus R Wagner
- Department of Biology, Program in Neuroscience, Syracuse University, Syracuse NY, United States
| | - Jessica L MacDonald
- Department of Biology, Program in Neuroscience, Syracuse University, Syracuse NY, United States.
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Zhong C, Tessing J, Lee BK, Lyall K. Maternal Dietary Factors and the Risk of Autism Spectrum Disorders: A Systematic Review of Existing Evidence. Autism Res 2020; 13:1634-1658. [PMID: 33015977 PMCID: PMC9234972 DOI: 10.1002/aur.2402] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/07/2020] [Accepted: 09/12/2020] [Indexed: 01/15/2023]
Abstract
Prenatal maternal diet is a critical factor in offspring neurodevelopment. Emerging evidence suggests that prenatal diet may also play a role in the etiology autism spectrum disorder (ASD). This review summarizes studies published in English that examined prenatal nutrients or maternal diet in association with ASD from PubMed as of July 2020. Thiry-six studies from nine countries were included in this systematic review; these focused on multivitamin (n = 5), prenatal vitamin (n = 3), folic acid (FA; n = 14), Vitamin D (n = 11), polyunsaturated fatty acid or fish/supplement intake (n = 7), iron (n = 3), Vitamin B12 (n = 1), calcium (n = 1), magnesium (n = 1), and broad maternal dietary habits (n = 3). Overall, higher or moderate intake of prenatal/multivitamin, FA, and Vitamin D was associated with reductions in odds of ASD, though results have not been uniform and there is a need to clarify differences in findings based on biomarkers versus reported intake. Evidence was inconclusive or insufficient for other nutrients. Differences in the timing and measurement of these dietary factors, as well as potential residual confounding, may contribute to existing discrepancies. Key areas for future research to better understand the role of maternal diet in ASD include the need to address potential critical windows, examine the combined effect of multiple nutrients, and consider interactions with genetic or environmental factors. LAY SUMMARY: Maternal diet during pregnancy is important for child neurodevelopment. We reviewed 36 studies examining maternal diet and autism spectrum disorder (ASD) and found that prenatal vitamin/multivitamin use and adequate intake of folic acid and Vitamin D were each associated with lower likelihood of having a child with ASD. Future studies on these and other dietary factors are needed to better understand the role of maternal diet in the development of ASD. Autism Res 2020, 13: 1634-1658. © 2020 International Society for Autism Research and Wiley Periodicals LLC.
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Affiliation(s)
- Caichen Zhong
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | | | - Brian K Lee
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | - Kristen Lyall
- A.J. Drexel Autism Institute, Philadelphia, Pennsylvania, USA
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Matsumura K, Hamazaki K, Tsuchida A, Inadera H. Prospective Association of Air-Purifier Usage during Pregnancy with Infant Neurodevelopment: A Nationwide Longitudinal Study-Japan Environment and Children's Study (JECS). J Clin Med 2020; 9:jcm9061924. [PMID: 32575520 PMCID: PMC7356334 DOI: 10.3390/jcm9061924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/30/2020] [Accepted: 06/16/2020] [Indexed: 11/16/2022] Open
Abstract
Fetal exposure to particulate matter (PM) is associated with infant developmental delay likely via neuroinflammation and prefrontal cortex lesions; however, whether air-purifier usage, which can reduce indoor PM levels, is related to infant developmental delay remains unknown. We therefore examined the prospective relationship between air-purifier usage during pregnancy and infant developmental delay by analyzing 82,441 mother-infant pairs using a simple yes/no questionnaire. Developmental delays at 6 and 12 months were assessed in five areas using the Ages and Stages Questionnaire, Third Edition. A generalized linear mixed model analysis was used to derive adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) while controlling for 20 covariates. The analysis revealed that air-purifier usage was associated with developmental delays in fine motor (AOR: 0.91, 95% CI: 0.83-0.99) and problem solving (AOR: 0.83, 95% CI: 0.77-0.90) at 6 months and in communication (AOR: 0.86, 95% CI: 0.79-0.93), fine motor (AOR: 0.87, 95% CI: 0.82-0.92), problem solving (AOR: 0.83, 95% CI: 0.77-0.88), and personal-social (AOR: 0.79, 95% CI: 0.72-0.86) at 12 months. In conclusion, a negative association exists between air-purifier usage during pregnancy and infant neurodevelopmental delay that strengthens with time. Our results outline the potential role of air purifiers in inhibiting infant neurodevelopmental delay.
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Affiliation(s)
- Kenta Matsumura
- Toyama Regional Center for Japan Environment and Children’s Study, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194, Japan; (K.H.); (A.T.); (H.I.)
- Correspondence: ; Tel.: +81-76-434-7277
| | - Kei Hamazaki
- Toyama Regional Center for Japan Environment and Children’s Study, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194, Japan; (K.H.); (A.T.); (H.I.)
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194, Japan
| | - Akiko Tsuchida
- Toyama Regional Center for Japan Environment and Children’s Study, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194, Japan; (K.H.); (A.T.); (H.I.)
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194, Japan
| | - Hidekuni Inadera
- Toyama Regional Center for Japan Environment and Children’s Study, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194, Japan; (K.H.); (A.T.); (H.I.)
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194, Japan
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Pacheva I, Ivanov I. Targeted Biomedical Treatment for Autism Spectrum Disorders. Curr Pharm Des 2020; 25:4430-4453. [PMID: 31801452 DOI: 10.2174/1381612825666191205091312] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 12/02/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND A diagnosis of autism spectrum disorders (ASD) represents presentations with impairment in communication and behaviour that vary considerably in their clinical manifestations and etiology as well as in their likely pathophysiology. A growing body of data indicates that the deleterious effect of oxidative stress, mitochondrial dysfunction, immune dysregulation and neuroinflammation, as well as their interconnections are important aspects of the pathophysiology of ASD. Glutathione deficiency decreases the mitochondrial protection against oxidants and tumor necrosis factor (TNF)-α; immune dysregulation and inflammation inhibit mitochondrial function through TNF-α; autoantibodies against the folate receptors underpin cerebral folate deficiency, resulting in disturbed methylation, and mitochondrial dysfunction. Such pathophysiological processes can arise from environmental and epigenetic factors as well as their combined interactions, such as environmental toxicant exposures in individuals with (epi)genetically impaired detoxification. The emerging evidence on biochemical alterations in ASD is forming the basis for treatments aimed to target its biological underpinnings, which is of some importance, given the uncertain and slow effects of the various educational interventions most commonly used. METHODS Literature-based review of the biomedical treatment options for ASD that are derived from established pathophysiological processes. RESULTS Most proposed biomedical treatments show significant clinical utility only in ASD subgroups, with specified pre-treatment biomarkers that are ameliorated by the specified treatment. For example, folinic acid supplementation has positive effects in ASD patients with identified folate receptor autoantibodies, whilst the clinical utility of methylcobalamine is apparent in ASD patients with impaired methylation capacity. Mitochondrial modulating cofactors should be considered when mitochondrial dysfunction is evident, although further research is required to identify the most appropriate single or combined treatment. Multivitamins/multiminerals formulas, as well as biotin, seem appropriate following the identification of metabolic abnormalities, with doses tapered to individual requirements. A promising area, requiring further investigations, is the utilization of antipurinergic therapies, such as low dose suramin. CONCLUSION The assessment and identification of relevant physiological alterations and targeted intervention are more likely to produce positive treatment outcomes. As such, current evidence indicates the utility of an approach based on personalized and evidence-based medicine, rather than treatment targeted to all that may not always be beneficial (primum non nocere).
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Affiliation(s)
- Iliyana Pacheva
- Department of Pediatrics and Medical Genetics, Medical University - Plovdiv, Plovdiv 4002, Bulgaria
| | - Ivan Ivanov
- Department of Pediatrics and Medical Genetics, Medical University - Plovdiv, Plovdiv 4002, Bulgaria
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Meador KJ, Pennell PB, May RC, Brown CA, Baker G, Bromley R, Loring DW, Cohen MJ. Effects of periconceptional folate on cognition in children of women with epilepsy: NEAD study. Neurology 2019; 94:e729-e740. [PMID: 31871217 DOI: 10.1212/wnl.0000000000008757] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 08/21/2019] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE Emerging evidence suggests potential positive neuropsychological effects of periconceptional folate in both healthy children and children exposed in utero to antiseizure medications (ASMs). In this report, we test the hypothesis that periconceptional folate improves neurodevelopment in children of women with epilepsy by re-examining data from the Neurodevelopmental Effects of Antiepileptic Drugs (NEAD) study. METHODS The NEAD study was an NIH-funded, prospective, observational, multicenter investigation of pregnancy outcomes in 311 children of 305 women with epilepsy treated with ASM monotherapy. Missing data points were imputed with Markov chain Monte Carlo methods. Multivariate analyses adjusted for multiple factors (e.g., maternal IQ, ASM type, standardized ASM dose, and gestational birth age) were performed to assess the effects of periconceptional folate on cognitive outcomes (i.e., Full Scale Intelligence Quotient [FSIQ], Verbal and Nonverbal indexes, and Expressive and Receptive Language indexes at 3 and 6 years of age, and executive function and memory function at 6 years of age). RESULTS Periconceptional folate was associated with higher FSIQ at both 3 and 6 years of age. Significant effects for other measures included Nonverbal Index, Expressive Language Index, and Developmental Neuropsychological Assessment Executive Function at 6 years of age, and Verbal Index and Receptive Language Index at 3 years of age. Nonsignificant effects included Verbal Index, Receptive Index, Behavior Rating Inventory of Executive Function-Parent Questionnaire Executive Function, and General Memory Index at 6 years of age, and Nonverbal Index and Expressive Index at 3 years of age. CONCLUSIONS Use of periconceptional folate in pregnant women with epilepsy taking ASMs is associated with better cognitive development. CLINICALTRIALSGOV IDENTIFIER NCT00021866.
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Affiliation(s)
- Kimford J Meador
- From the Department of Neurology and Neurological Sciences (K.J.M.), Stanford University, CA; Department of Neurology (P.B.P.), Brigham and Women's Hospital, Harvard Medical School, Boston; The Emmes Corporation (R.C.M., C.A.B.), Rockville, MD; Walton Centre for Neurology & Neurosurgery (G.B.), University of Liverpool, Merseyside; Division of Evolution and Genomic Science (R.B.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Departments of Neurology and Pediatrics (D.W.L.), Emory University, Atlanta; and Pediatric Neuropsychology International (M.J.C.), Augusta, GA.
| | - Page B Pennell
- From the Department of Neurology and Neurological Sciences (K.J.M.), Stanford University, CA; Department of Neurology (P.B.P.), Brigham and Women's Hospital, Harvard Medical School, Boston; The Emmes Corporation (R.C.M., C.A.B.), Rockville, MD; Walton Centre for Neurology & Neurosurgery (G.B.), University of Liverpool, Merseyside; Division of Evolution and Genomic Science (R.B.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Departments of Neurology and Pediatrics (D.W.L.), Emory University, Atlanta; and Pediatric Neuropsychology International (M.J.C.), Augusta, GA
| | - Ryan C May
- From the Department of Neurology and Neurological Sciences (K.J.M.), Stanford University, CA; Department of Neurology (P.B.P.), Brigham and Women's Hospital, Harvard Medical School, Boston; The Emmes Corporation (R.C.M., C.A.B.), Rockville, MD; Walton Centre for Neurology & Neurosurgery (G.B.), University of Liverpool, Merseyside; Division of Evolution and Genomic Science (R.B.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Departments of Neurology and Pediatrics (D.W.L.), Emory University, Atlanta; and Pediatric Neuropsychology International (M.J.C.), Augusta, GA
| | - Carrie A Brown
- From the Department of Neurology and Neurological Sciences (K.J.M.), Stanford University, CA; Department of Neurology (P.B.P.), Brigham and Women's Hospital, Harvard Medical School, Boston; The Emmes Corporation (R.C.M., C.A.B.), Rockville, MD; Walton Centre for Neurology & Neurosurgery (G.B.), University of Liverpool, Merseyside; Division of Evolution and Genomic Science (R.B.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Departments of Neurology and Pediatrics (D.W.L.), Emory University, Atlanta; and Pediatric Neuropsychology International (M.J.C.), Augusta, GA
| | - Gus Baker
- From the Department of Neurology and Neurological Sciences (K.J.M.), Stanford University, CA; Department of Neurology (P.B.P.), Brigham and Women's Hospital, Harvard Medical School, Boston; The Emmes Corporation (R.C.M., C.A.B.), Rockville, MD; Walton Centre for Neurology & Neurosurgery (G.B.), University of Liverpool, Merseyside; Division of Evolution and Genomic Science (R.B.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Departments of Neurology and Pediatrics (D.W.L.), Emory University, Atlanta; and Pediatric Neuropsychology International (M.J.C.), Augusta, GA
| | - Rebecca Bromley
- From the Department of Neurology and Neurological Sciences (K.J.M.), Stanford University, CA; Department of Neurology (P.B.P.), Brigham and Women's Hospital, Harvard Medical School, Boston; The Emmes Corporation (R.C.M., C.A.B.), Rockville, MD; Walton Centre for Neurology & Neurosurgery (G.B.), University of Liverpool, Merseyside; Division of Evolution and Genomic Science (R.B.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Departments of Neurology and Pediatrics (D.W.L.), Emory University, Atlanta; and Pediatric Neuropsychology International (M.J.C.), Augusta, GA
| | - David W Loring
- From the Department of Neurology and Neurological Sciences (K.J.M.), Stanford University, CA; Department of Neurology (P.B.P.), Brigham and Women's Hospital, Harvard Medical School, Boston; The Emmes Corporation (R.C.M., C.A.B.), Rockville, MD; Walton Centre for Neurology & Neurosurgery (G.B.), University of Liverpool, Merseyside; Division of Evolution and Genomic Science (R.B.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Departments of Neurology and Pediatrics (D.W.L.), Emory University, Atlanta; and Pediatric Neuropsychology International (M.J.C.), Augusta, GA
| | - Morris J Cohen
- From the Department of Neurology and Neurological Sciences (K.J.M.), Stanford University, CA; Department of Neurology (P.B.P.), Brigham and Women's Hospital, Harvard Medical School, Boston; The Emmes Corporation (R.C.M., C.A.B.), Rockville, MD; Walton Centre for Neurology & Neurosurgery (G.B.), University of Liverpool, Merseyside; Division of Evolution and Genomic Science (R.B.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Departments of Neurology and Pediatrics (D.W.L.), Emory University, Atlanta; and Pediatric Neuropsychology International (M.J.C.), Augusta, GA
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Taylor EH, Gandhi B, Marleen S, Hooper RL, Aquilina J, Martineau AR. Seasonal variation in fetal lateral cerebral ventricular diameter. Prenat Diagn 2019; 40:390-392. [PMID: 31663133 DOI: 10.1002/pd.5586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 09/24/2019] [Accepted: 10/09/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Elliott H Taylor
- Barts Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Balaganesh Gandhi
- Barts Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Shemoon Marleen
- Department of Obstetrics and Gynecology, The Royal London Hospital, Barts Health NHS Trust, London, UK.,Sri Jayewardenepura Postgraduate Teaching Hospital, Colombo, Sri Lanka
| | - Richard L Hooper
- Barts Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Joseph Aquilina
- Barts Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Department of Obstetrics and Gynecology, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Adrian R Martineau
- Barts Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Abstract
PURPOSE OF REVIEW This article provides the latest information to guide practitioners in counseling and treating women with epilepsy. RECENT FINDINGS There is an increasing body of literature on the multidirectional effects of sex hormones on seizure frequency and severity and of seizures altering areas of the brain involved in neuroendocrine function. Ongoing pregnancy outcome data from pregnancy registries and meta-analysis of observational studies have provided key information on the safety of using antiseizure medications during pregnancy and the risk to the fetus. SUMMARY In treating and counseling women with epilepsy from puberty to menopause, it is important to understand the complex interactions of sex hormones, seizures, and antiseizure medications on reproductive health and pregnancy outcomes.
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