Folate levels in pregnancy and offspring food allergy and eczema.
Eczema
cohort
folate status
folic acid
food allergy
paediatrics
pregnancy
Journal
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology
ISSN: 1399-3038
Titre abrégé: Pediatr Allergy Immunol
Pays: England
ID NLM: 9106718
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
received:
01
04
2019
revised:
09
09
2019
accepted:
16
09
2019
pubmed:
1
10
2019
medline:
15
12
2020
entrez:
1
10
2019
Statut:
ppublish
Résumé
High folate status in pregnancy has been implicated in the increased prevalence of allergic disease, but there are no published data relating directly measured folate status in pregnancy to challenge-proven food allergy among offspring. The study aim was to examine the association between red blood cell (RBC) folate status in trimester three of pregnancy and allergic disease among offspring. Red blood cell folate levels were measured at 28-32 weeks' gestation in a prospective birth cohort (n = 1074). Food allergy outcomes were assessed in 1-year-old infants by skin prick testing and subsequent food challenge. Eczema was assessed by questionnaire and clinical review. High trimester three RBC folate was defined as greater than (>) 1360 nmol/L. Binomial regression was used to examine associations between trimester three RBC folate and allergic outcomes, adjusting for potential confounders. Red blood cell folate levels were measured in 88% (894/1064) of pregnant women. The mean concentration was 1695.6 nmol/L (standard deviation 415.4) with 82% (731/894) >1360 nmol/L. There was no evidence of either linear or non-linear relationships between trimester three RBC folate and allergic outcomes, nor evidence of associations between high RBC folate and food allergy (adjusted risk ratio (aRR) 2.89, 95% CI 0.90-9.35), food sensitization (aRR 1.72, 95% CI 0.85-3.49), or eczema (aRR 0.97, 95% CI 0.67-1.38). The majority of pregnant women in this study had high RBC folate levels. There was no evidence of associations between trimester three RBC folate and food allergy, food sensitization, or eczema among the offspring, although larger studies are required.
Sections du résumé
BACKGROUND
High folate status in pregnancy has been implicated in the increased prevalence of allergic disease, but there are no published data relating directly measured folate status in pregnancy to challenge-proven food allergy among offspring. The study aim was to examine the association between red blood cell (RBC) folate status in trimester three of pregnancy and allergic disease among offspring.
METHODS
Red blood cell folate levels were measured at 28-32 weeks' gestation in a prospective birth cohort (n = 1074). Food allergy outcomes were assessed in 1-year-old infants by skin prick testing and subsequent food challenge. Eczema was assessed by questionnaire and clinical review. High trimester three RBC folate was defined as greater than (>) 1360 nmol/L. Binomial regression was used to examine associations between trimester three RBC folate and allergic outcomes, adjusting for potential confounders.
RESULTS
Red blood cell folate levels were measured in 88% (894/1064) of pregnant women. The mean concentration was 1695.6 nmol/L (standard deviation 415.4) with 82% (731/894) >1360 nmol/L. There was no evidence of either linear or non-linear relationships between trimester three RBC folate and allergic outcomes, nor evidence of associations between high RBC folate and food allergy (adjusted risk ratio (aRR) 2.89, 95% CI 0.90-9.35), food sensitization (aRR 1.72, 95% CI 0.85-3.49), or eczema (aRR 0.97, 95% CI 0.67-1.38).
CONCLUSION
The majority of pregnant women in this study had high RBC folate levels. There was no evidence of associations between trimester three RBC folate and food allergy, food sensitization, or eczema among the offspring, although larger studies are required.
Substances chimiques
Folic Acid
935E97BOY8
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
38-46Informations de copyright
© 2019 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
Références
Wald N, Sneddon J, Densem J, et al. Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group. Lancet. 1991;338:131-137.
Finer LB, Henshaw SK. Disparities in rates of unintended pregnancy in the United States, 1994 and 2001. Perspect Sex Reprod Health. 2006;38:90-96.
Khoshnood B, Loane M, de Walle H, et al. Long term trends in prevalence of neural tube defects in Europe: population based study. BMJ. 2015;351:h5949.
Castillo-Lancellotti C, Tur JA, Uauy R. Impact of folic acid fortification of flour on neural tube defects: a systematic review. Public Health Nutr. 2013;16:901-911.
Jacques PF, Selhub J, Bostom AG, Wilson PW, Rosenberg IH. The effect of folic acid fortification on plasma folate and total homocysteine concentrations. N Engl J Med. 1999;340:1449-1454.
Branum AM, Bailey R, Singer BJ. Dietary supplement use and folate status during pregnancy in the United States. J Nutr. 2013;143:486-492.
Dunstan JA, West C, McCarthy S, et al. The relationship between maternal folate status in pregnancy, cord blood folate levels, and allergic outcomes in early childhood. Allergy. 2012;67:50-57.
Joubert BR, den Dekker HT, Felix JF, et al. Maternal plasma folate impacts differential DNA methylation in an epigenome-wide meta-analysis of newborns. Nat Commun. 2016;7:10577.
Haberg SE, London SJ, Stigum H, Nafstad P, Nystad W. Folic acid supplements in pregnancy and early childhood respiratory health. Arch Dis Child. 2009;94:180-184.
Kiefte-de Jong JC, Timmermans S, Jaddoe VW, et al. High circulating folate and vitamin B-12 concentrations in women during pregnancy are associated with increased prevalence of atopic dermatitis in their offspring. J Nutr. 2012;142:731-738.
Bekkers MB, Elstgeest LE, Scholtens S, et al. Maternal use of folic acid supplements during pregnancy, and childhood respiratory health and atopy. Eur Respir J. 2012;39:1468-1474.
Magdelijns FJ, Mommers M, Penders J, Smits L, Thijs C. Folic acid use in pregnancy and the development of atopy, asthma, and lung function in childhood. Pediatrics. 2011;128:e135-e144.
Lucock M. Folic acid: nutritional biochemistry, molecular biology, and role in disease processes. Mol Genet Metab. 2000;71:121-138.
Vuillermin P, Saffery R, Allen KJ, et al. Cohort profile: the barwon infant study. Int J Epidemiol. 2015;44:1148-1160.
Pfeiffer CM, Johnson CL, Jain RB, et al. Trends in blood folate and vitamin B-12 concentrations in the United States, 1988 2004. Am J Clin Nutr. 2007;86:718-727.
Daly LE, Kirke PN, Molloy A, Weir DG, Scott JM. Folate levels and neural tube defects. Implications for prevention. JAMA. 1995;274:1698-1702.
Selhub J, Jacques PF, Dallal G, Choumenkovitch S, Rogers G. The use of blood concentrations of vitamins and their respective functional indicators to define folate and vitamin B12 status. Food Nutr Bull. 2008;29:S67-S73.
Giles G, Ireland P. Dietary questionnaire for epidemiological studies (version 2). Melbourne: The Cancer Council Victoria; 1996.
Capra S.Nutrient reference values for Australia and New Zealand: Including recommended dietary intakes; 2006.
Allen KJ, Koplin JJ, Ponsonby AL, et al. Vitamin D insufficiency is associated with challenge-proven food allergy in infants. J Allergy Clin Immunol. 2013;131(4): 1109-1116.e6.
Williams HC, Burney PG, Pembroke AC, Hay RJ, The UK. Working party's diagnostic criteria for atopic dermatitis. III. independent hospital validation. Br J Dermatol. 1994;131:406-416.
Pucci N, Novembre E, Cammarata MG, et al. Scoring atopic dermatitis in infants and young children: distinctive features of the SCORAD index. Allergy. 2005;60:113-116.
Pink B. An Introduction to Socio-Economic Indexes for Areas (SEIFA). Canberra, ACT: Australian Bureau of Statistics; 2006.
Plumptre L, Masih SP, Ly A, et al. High concentrations of folate and unmetabolized folic acid in a cohort of pregnant Canadian women and umbilical cord blood. Am J Clin Nutr. 2015;102:848-857.
Malek L, Umberger W, Makrides M, Zhou SJ. Poor adherence to folic acid and iodine supplement recommendations in preconception and pregnancy: a cross-sectional analysis. Aust N Z J Public Health. 2016;40:424-429.
Statistics ABo, Australian Health Survey: biomedical results for nutrients, 2011-12: Canberra: Australian Bureau of statistics; 2013.
Tinker SC, Hamner HC, Qi YP, Crider KS. U.S. women of childbearing age who are at possible increased risk of a neural tube defect-affected pregnancy due to suboptimal red blood cell folate concentrations, National Health and Nutrition Examination Survey 2007 to 2012. Birth Defects Res A Clin Mol Teratol. 2007;2015(103):517-526.
Peake JN, Copp AJ, Shawe J. Knowledge and periconceptional use of folic acid for the prevention of neural tube defects in ethnic communities in the United Kingdom: systematic review and meta-analysis. Birth Defects Res A Clin Mol Teratol. 2013;97:444-451.
Martino D, Neeland M, Dang T, et al. Epigenetic dysregulation of naive CD4+ T-cell activation genes in childhood food allergy. Nat Commun. 2018;9:3308.
Pfeiffer CM, Sternberg MR, Hamner HC, et al. Applying inappropriate cutoffs leads to misinterpretation of folate status in the US population. Am J Clin Nutr. 2016;104:1607-1615.
McGowan EC, Hong X, Selhub J, et al. Association between folate metabolites and the development of food Allergy in Children. J Allergy Clin Immunol Pract. 2019. https://doi.org/10.1016/j.jaip.2019.06.017 (in press)
Liew SC, Gupta ED. Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism: epidemiology, metabolism and the associated diseases. Eur J Med Genet. 2015;58:1-10.
McStay CL, Prescott SL, Bower C, Palmer DJ. Maternal folic acid supplementation during pregnancy and childhood allergic disease outcomes: a question of timing? Nutrients. 2017;9(2):123.