Trusted Information for Healthy Pregnancies
Folic Acid
Mom’s Lifestyle in Early Pregnancy Affects Baby’s Size
Feb 10th
The lifestyle habits you bring into pregnancy can have lasting effects on your baby's health, new research shows.
A Dutch study found that women who smoked, had high blood pressure or low folic acid levels in early pregnancy had babies that were smaller in the first trimester of pregnancy and had a higher risk of complications later.
"Our study demonstrates that several maternal physical characteristics and lifestyle habits, such as smoking and non-use of folic acid supplements, affect first-trimester fetal growth," said study senior author Dr. Vincent Jaddoe, a pediatric epidemiologist at Erasmus Medical Center in Rotterdam, the Netherlands.
"First-trimester growth restriction is associated with higher risks of adverse birth outcomes and accelerated postnatal growth rates. Thus, the first trimester of pregnancy seems to be a very critical period for fetal growth and development. This is important, since it suggests that the fetus is already affected before pregnant women visit their midwife or obstetrician," he said.
For the study, published in the Feb. 10 issue of the Journal of the American Medical Association, the researchers followed 1,631 pregnant women from their first trimester through their pregnancies. The growth of their offspring was assessed until the children were 2.
The average age of the mothers was 31, and 71 percent were white. More than half had a higher than high school education. The average body mass index was 23.5, which is normal (over 25 is considered overweight). About one-quarter smoked at the start of the study.
The researchers found that certain factors affected the likelihood that a fetus would have a small crown to rump length (a standard way to measure babies using ultrasound). Babies whose mothers smoked or had higher diastolic blood pressure readings (diastolic is the bottom number in blood pressure) were more likely to be smaller. Women who didn't use folic acid supplements and those with higher levels of red blood cells also had smaller babies, according to the study.
A small size during the first trimester translated to a higher risk of certain complications later in the pregnancy, such as preterm birth and low birth weight.
Babies that had first-trimester growth restriction had 7.2 percent odds of being born preterm compared to 4 percent for babies who weren't growth-restricted. Odds of low birth weight were 7.5 percent for growth-restricted babies compared to 3.5 percent for other babies. And, the odds of being born small-for-gestational-age were 10.6 percent for babies who were growth-restricted compared to 4 percent for babies who grew normally during early pregnancy.
Jaddoe and Dr. Gordon Smith, author of an accompanying editorial in the same issue of the journal, believe that when a woman is exposed to poor lifestyle habits in early pregnancy, it may affect development of the placenta, which then affects the fetus' ability to survive and thrive.
The bottom line for women is that it's important to go to the doctor before getting pregnant to find out what steps to take to ensure that you're in the best shape possible before you get pregnant, such as quitting smoking and taking folic acid supplements.
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Folic Acid May Help Prevent Fetal Heart Defects
Dec 9th
Here's another reason for pregnant women to take folic acid supplements: they help prevent fetal heart malformations, new research from the Netherlands suggests.
"Given the relatively high prevalence of congenital heart defects worldwide, our findings are important for public health," Dr. Ingrid M. van Beynum of Radboud University in Nijmegen and her colleagues write.
Folic acid supplements are now recommended for all pregnant women, and women planning on becoming pregnant, in order to prevent birth defects involving the neural tube such as spina bifida. Many countries, including the US, now require bread and other wheat products to be fortified with folic acid for this reason, but this practice hasn't been adopted in The Netherlands.
To investigate further, the researchers used a national register of birth defects to identify 611 mothers who had given birth to a child with a heart defect, matching them to 2,401 women who delivered babies with genetic defects or other birth defects unrelated to folate.
Women who took a supplement containing at least 400 micrograms of folic acid were nearly 20 percent less likely to have a child with a heart defect, compared to other non-folate-related malformations, while their risk compared to the general population was 26 percent lower.
Their risk of having a child with a heart defect involving the septum -- which separates one side of the heart from the other -- was nearly 40 percent lower than that of the general population.
The current study couldn't show whether taking more or less than 400 micrograms of folic acid would be more effective in preventing heart defects, the researchers note, although there's increasing evidence that heavier women may need to take more folic acid to get the same protective effects.
The researchers conclude that women who want to become pregnant should take folic acid supplements around the time of conception, not only to prevent neural tube defects but also to reduce the risk of congenital heart defects.
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FDA Updates Warning for Pregnant Women on Antiepileptic Drugs
Dec 4th
The FDA has issued a statement reminding patients and doctors that valproate sodium, valproic acid, and divalproex products increase the risk of birth defects in babies exposed to the chemicals during pregnancy.
The medications - used to treat epilepsy since 1978 and more recently for bipolar disorder and migraine - can cause neural tube defects, craniofacial defects, and cardiovascular malformations in unborn children during the first trimester. This is often before many women know they are pregnant, the FDA said in a statement.
Use of the products increases neural tube defects during the first 12 weeks of pregnancy from one in 1,500 to one in 20, on average, the FDA noted.
Babies born to women taking valproate for epilepsy are more than three times as likely to have birth defects as those born to women on a different therapy (10.7%, 95% CI 6.3% to 16.9% versus 2.9%, 95% CI 2.0% to 4.1%), according to data from the North American Antiepileptic Drug Pregnancy Registry.
The FDA cautioned women of childbearing potential to take valproate only if it is essential for managing a medical condition. Those taking the drug who are not planning pregnancy should use contraception, the agency said.
Women planning to become pregnant can reduce the risk of congenital neural tube defects by taking folic acid before and during the first trimester of pregnancy, the FDA noted.
The agency also noted a danger to pregnant mothers and their child if epilepsy or bipolar disorder is left untreated while the baby is developing. Likewise, it reminded doctors and patients of a major risk associated with ceasing valproate therapy suddenly.
The FDA recommended that women talk with healthcare professionals before stopping use of valproate products if they become pregnant.
It also recommended women who become pregnant while taking valproate or other antiepileptic drugs enroll in the North American Antiepileptic Drug Pregnancy Registry to help gather more information on the safety of the medications during pregnancy.
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Low Folate Levels in Pregnancy Tied to ADHD
Nov 4th
Low folate levels during pregnancy are associated with higher odds for attention-deficit/hyperactivity disorder in offspring aged 7 to 9, new research has found.
The findings seem to support the long-held belief that folate (folic acid) levels in expectant mothers influence their children's nervous system development.
The researchers also found that children of mothers with low folate levels had notably smaller head circumference at birth, which may indicate a slower rate of prenatal brain growth.
The study was released online Oct. 28 in advance of publication in an upcoming print issue of the Journal of Child Psychology and Psychiatry.
The results are special cause for concern in relation to low-income families, where a mother's nutritional health receives a low priority, and women are less likely to take folic acid supplements prior to becoming pregnant.
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Study Links Folic Acid Supplement in Late Pregnancy to Asthma in Offspring
Nov 4th
Women who take folic acid supplements during the later months of pregnancy may be increasing their baby's risk of developing asthma, according to a newly released Australian study.
Found in its natural form in leafy green vegetables, legumes and some nuts, folic acid is commonly recommended to women trying to conceive to prevent neural defects in the first weeks of pregnancy.
But the Australian study found that women who continue to take folic acid late into pregnancy were 30 percent more likely to give birth to a child which would develop asthma.
"We see a substantial proportion of women taking these folate supplements throughout pregnancy, and it may be because people think it is entirely benign," said Michael Davies, associate professor at Adelaide University.
"Folate is incredibly important because of its role in preventing neural tube defects (like spina bifida). But because it is so important, and so bioactive, it needs to be treated with some respect as well."
Of the 550 women studied, those who took the folic acid supplements before conception and not more than several weeks into their pregnancy had no increased risk of asthma in their children.
But women who took it during weeks 16 to 30 of the pregnancy increased their risk of having a child with asthma by about 30 percent, according to the research, published in the American Journal of Epidemiology.
"Our finding should be reassuring to women who take folate for the purpose of preventing neural tube defects because we found no evidence of early supplementation (leading to asthma)," Davies told newswire AAP.
Davies said a diet rich in natural folate carried no increased risk of asthma for the baby.
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