Elevated Maternal Serum Folate in the Third Trimester and Reduced Fetal Growth: A Longitudinal Study

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  • TAKIMOTO Hidemi
    Department of Health Promotion, National Institute of Public Health
  • HAYASHI Fumi
    Department of Nutrition, Chiba Prefectural University of Health Sciences
  • KUSAMA Kaoru
    Department of Nutrition, Yamaguchi Prefectural University
  • KATO Noriko
    Department of Health Promotion, National Institute of Public Health
  • YOSHIIKE Nobuo
    Department of Nutrition, Aomori University of Health and Welfare
  • TOBA Mikayo
    Department of Obstetrics and Gynecology, Tokyo Medical and Dental University
  • ISHIBASHI Tomoko
    Department of Gynecology, Kawaguchi Kogyo General Hospital
  • MIYASAKA Naoyuki
    Department of Regional Pediatric and Perinatal Health Care, Tokyo Medical and Dental University
  • KUBOTA Toshiro
    Department of Obstetrics and Gynecology, Tokyo Medical and Dental University

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This study aimed to examine the association of fetal growth and elevated third trimester maternal serum folate due to folic acid (FA) supplement intake. Dietary intake, use of FA supplements, weight, and blood biomarkers of B-vitamins (serum folate, pyridoxal, vitamin B12, and plasma total homocysteine) were observed in 33 healthy pregnant women at the third trimester (average gestational age 35 wk). Birth outcomes were assessed through hospital birth records. Infant anthropometry and maternal blood biomarkers were followed up at 1 mo postpartum. Fourteen women were taking FA supplements at the third trimester. Dietary intake was similar among FA users and non-users, but serum folate and pyridoxal were significantly higher in users (11.6±6.7 vs. 6.1±3.2 ng/mL, and 13.8±21.7 vs. 3.2±1.4 ng/mL, respectively). Plasma total homocystein (tHcy) was higher in non-users compared to users, but not significantly. Nine FA users and eight non-users had low serum vitamin B12 values (<203 pg/mL). Nine FA users and all non-users had low serum pyridoxal values (<7.0 ng/mL). Infant birthweight was significantly lower in users compared to non-users (2,894±318 vs. 3,154±230 g). At 1 mo postpartum, infant weight and length were similar between FA users and non-users, but infant weight gain was larger in users. Higher serum folate values due to FA use in the third trimester was related to reduced fetal size. Excess FA under low vitamin B6 and B12 status may affect fetal growth.

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