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Epidemiology

Maternal folate levels during pregnancy and children’s neuropsychological development at 2 years of age

European Journal of Clinical Nutrition volume 74, pages 1585–1593 (2020)Cite this article

Subjects

Abstract

Objective

To explore the relationship between maternal folate levels during pregnancy and children’s neuropsychological development at 2 years of age.

Methods

In the birth cohort MKFOAD, maternal serum folate concentrations at 12–14, 22–26, and 34–36 weeks of gestation were measured, as well as red blood cell (RBC) folate at 12–14 weeks. Neurodevelopment of 2-year-old children was assessed by Gesell Development Scale (GDS), which contained subscales of gross motor, fine motor, language, adaptive behavior, and social behavior. Linear regression models were applied to investigate the association of maternal folate levels with children’s developmental quotients (DQs).

Results

One hundred and eighty singleton children participated the GDS assessment, of whom 97 (53.9%) were boys. Median RBC folate concentration was 1002.8 (IQR = 577.6) nmol L−1 in early pregnancy and median serum folate concentrations were, respectively, 33.9 (IQR = 9.2) nmol L−1, 26.3 (IQR = 14.3) nmol L−1, and 26.7 (IQR = 18.9) nmol L−1. Maternal serum folate concentration in late pregnancy was significantly associated with children’s language development, where language DQ increases by 3.1 (95% CI 0.6, 5.5) for every 10 nmol L−1 increment of serum folate concentration. And maternal serum folate in early pregnancy was significantly associated with children’s fine motor development, with 2.0 (95% CI 0.1, 4.0) DQ decrease for 10 nmol L−1 increase of serum folate.

Conclusions

Maternal serum folate in late pregnancy was significantly associated with children’s language development at age 2, which supports the importance of remaining folic acid supplementation across the entire gestation. However, maternal serum folate in early pregnancy was also inversely associated with children’s fine motor development.

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Fig. 1: Flow diagram of subject selection.
Fig. 2: Distribution of maternal serum folate at early, mid, and late pregnancy and RBC folate at early pregnancy.

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Acknowledgements

The authors gratefully thank all of the participants in this study and Minhang Maternal and Child Health Hospital for supporting this study.

Funding

This work was supported by National key research and development program (Grant No: 2016YFC1000500), Shanghai Public Health Three-Year Action Plan (Grant No:2015–82), and Canada-China Clinical Research program (Grant No: 201607).

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Author notes

  1. These authors contributed equally: Xiangyuan Huang, Ying Ye

Authors and Affiliations

  1. Department of Clinical Epidemiology, Children’s Hospital of Fudan University, Shanghai, China

    Xiangyuan Huang, Ying Ye, Yi Zhang, Yuan Jiang, Xiaotian Chen & Weili Yan

  2. Department of Dermatology, Children’s Hospital of Fudan University, Shanghai, China

    Ying Ye & Liuhui Wang

  3. Department of Child Health, Minhang Maternal and Child Health Hospital, Shanghai, China

    Yun Li & Ying Zhang

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Contributions

XYH and YY acquired data, analyzed the data, drafted and revised the manuscript. YL and YingZ acquired data and revised the manuscript, YiZ, XTC, YJ, and LHW played an important role in interpreting the results and revised the manuscript. WLY conceived and designed the work, revised the manuscript and made final approval of the work. All authors approved the final version and agree to be fully accountable for ensuring the integrity and accuracy of the work.

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Correspondence to Weili Yan.

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Huang, X., Ye, Y., Li, Y. et al. Maternal folate levels during pregnancy and children’s neuropsychological development at 2 years of age. Eur J Clin Nutr 74, 1585–1593 (2020). https://doi.org/10.1038/s41430-020-0612-9

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