Premium
Erythrocyte folate, plasma folate and plasma homocysteine during normal pregnancy and postpartum: a longitudinal study comprising 404 Danish women
Author(s) -
Milman Nils,
Byg KeldErik,
Hvas AnneMette,
Bergholt Thomas,
Eriksen Lisbeth
Publication year - 2006
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.2005.00606.x
Subject(s) - pregnancy , medicine , homocysteine , multivitamin , vitamin b12 , gestation , postpartum period , endocrinology , obstetrics , vitamin , biology , genetics
Objective : To assess folate and homocysteine status during normal pregnancy and postpartum in a longitudinal setting. Methods : This study, performed in 1995–1996, comprised 404 healthy pregnant Danish Caucasian women residential in Copenhagen County. Women taking folic acid tablets or vitamin B 12 injections were not included. Dietary multivitamin supplements containing folic acid 100 μ g or vitamin B 12 1 μ g, taken by 34%, were discontinued at inclusion. Participants had normal renal function. Folate status [erythrocyte (Ery‐) folate, plasma (P‐) folate, P‐homocysteine] was measured at 18, 32 and 39 wk of gestation and 8 wk postpartum when the women were lactating. Results : Through 18, 32 and 39 wk of gestation and postpartum, P‐folate demonstrated a significant fall: median values were 14.4, 10.2, 9.3 and 8.9 nmol/L, respectively ( P < 0.0001). The prevalence of low P‐folate <6 nmol/L increased during pregnancy from 0.7% to 19.0% postpartum ( P < 0.0001). Ery‐folate displayed a similar, significant fall: median value was 0.84, 0.75, 0.65 and 0.55 μ mol/L, respectively ( P < 0.0001). The prevalence of low Ery‐folate <0.40 μ mol/L increased during pregnancy from 0.5% to 17.2% postpartum ( P < 0.0001). P‐homocysteine demonstrated a significant increase: median value was 6.4, 7.0, 7.7 and 10.8 μ mol/L, respectively ( P < 0.0001). The prevalence of P‐homocysteine >13 μ mol/L increased during pregnancy from 0.7% to 20.8% postpartum ( P < 0.0001). The prevalence of low folate status (defined as P‐folate <6 nmol/L and P‐homocysteine >13 μ mol/L) was 0%, 0%, 1.2%, and 8.4% at 18, 32 and 39 wk of gestation and 8 wk postpartum, respectively. Conclusion : Low folate status occurs among Danish pregnant women, especially in late pregnancy and postpartum during lactation. Despite new guidelines for folic acid supplement since 1997, only 13% of pregnant women followed the guidelines in 2003. The official recommendations for periconceptional folic acid supplement should be reconsidered and reinforced.