An optimal periconception maternal folate status for embryonic size: the Rotterdam Predict study

Objective To investigate the association between periconception maternal folate status and embryonic size. Design Prospective periconception cohort study. Setting Erasmus University Medical Centre, Rotterdam, the Netherlands. Population Seventy‐seven singleton pregnancies recruited in 2009 and 2010....

Full description

Saved in:
Bibliographic Details
Published in:BJOG : an international journal of obstetrics and gynaecology 2014-06, Vol.121 (7), p.821-829
Main Authors: Uitert, EM, Ginkel, S, Willemsen, SP, Lindemans, J, Koning, AHJ, Eilers, PHC, Exalto, N, Laven, JSE, Steegers, EAP, Steegers‐Theunissen, RPM
Format: Article
Language:English
Subjects:
Adult
Crown-Rump Length
Embryology
embryonic growth
Female
Folic Acid - blood
Humans
Netherlands
Predictive Value of Tests
Pregnancy
Pregnancy Trimester, First
Prospective Studies
RBC folate
Size
Ultrasonography, Prenatal
Vitamin B
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective To investigate the association between periconception maternal folate status and embryonic size. Design Prospective periconception cohort study. Setting Erasmus University Medical Centre, Rotterdam, the Netherlands. Population Seventy‐seven singleton pregnancies recruited in 2009 and 2010. Methods We recruited women before 8 weeks of gestation and performed weekly three‐dimensional ultrasound scans from enrolment up to 13 weeks of gestation. As a measure of embryonic growth, crown–rump length (CRL) measurements were performed using V‐Scope software in the BARCO I‐Space. Maternal blood was collected to determine first‐trimester long‐term red blood cell (RBC) folate status. Non‐malformed live births were included in the analysis. We calculated quartiles of RBC folate, square root‐transformed CRL data and performed multivariable linear mixed model analyses. Main outcome measures Serial first‐trimester CRL measurements. Results In total, 484 ultrasound scans were performed in 77 women, in 440 (90.7%) of which CRLs could be measured. RBC folate in the third quartile (1513–1812 nmol/l) was significantly associated with an increased CRL compared with the first two quartiles (814–1512 nmol/l) and the upper quartile (1813–2936 nmol/l; Poverall = 0.03; adjusted for gestational age, smoking, body mass index and fetal sex). Compared with the third quartile, embryos in the upper quartile were 24.2% smaller at 6+0 weeks [4.1 mm (95% confidence interval 3.5, 4.7) versus 5.4 mm (95% confidence interval 4.8, 6.1)] and 7.6% smaller at 12+0 weeks [55.1 mm (95% confidence interval 52.9, 57.3) versus 59.6 mm (95% confidence interval 57.4, 62.0)] of gestation. Conclusions This study suggests that a very high maternal periconception folate status is associated with reduced embryonic size. Whether these effects are beneficial or harmful requires further investigation.
ISSN:1470-0328
1471-0528
DOI:10.1111/1471-0528.12592