Journal of the Korean Society of Food Science and Nutrition
/
v.26
no.5
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pp.983-992
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1997
During pregnancy and lactation, folate status is important because folate requirements increase during the periods as well as maternal folate status influences on pregnancy outcome and human milk folate; especially folate deficiency around periconceptional period may induce neural tube defects(NTDs) of fetus. There have been a plenty of evidences that maternal folate status deteriorates during pregnancy of fetus. There have been a plenty of evidences that maternal folate status deteriorates during pregnancy and lactation if folate needed is not sufficiently provided. The Public health Service of the United States recommends all child-bearing is not sufficiently provided. The Public Health Service of the United States recommends all child-bearing women to intake 0.4mg of folate daily, and the Food and Drug Administration the folate status of child-bearing women and to reduce the rate of occurrence of NTDs. Many authors have insisted that the current recommended dietary allowances of folate for Americans are too low to maintain good folate status. There are little data about Korean folate status including pregant and lactating women. A couple of reports indicated that the folate intakes of Korean pregant and lactating women are below the Korean RDAs of folate and serum folate levels of them are subnormal. The authors pregnant and lactating women. Therefore, it is worth to review the assessment methods of folate status of pregnant and lactating women, folate RDAs for them, the relationships between maternal folate status and pregnancy outcome as well as human milk folate, the methods to increase folate intake, and the problems of large dose of folic acid supplementatiion.
This study was out to evaluate the folate nutritional status of Korean pregnant women and to investigate the relationship between serum folate levels of maternal-umbilical cord blood and pregnancy outcomes. Folate intakes of the pregnants was estimated by dietary folate intakes obtained from semiquantitative frequency questionnaire and supplementary folate intakes. The serum folate levels in both maternal blood and umbilical cord of 29 pregnant women at delivery and 13 nonpregnant controls were measured by redioimmunoassay. The total folate intakes(dietary and supplementary)of the pregnant women was 465. 4$\mu\textrm{g}$/d which was 93% of the Korean RDA for folate. Maternal mean serum folate levels of the pregnants was 6.1$\mu\textrm{g}$/ml, significantly lower than that of nonpregnant women(8.9ng/ml). Mean serumfolate level of umbilical cord blood was 14.2ng/ml, which was 2.3 folds higher than that of maternal blood. This finding indicates that the uptake of folate in the fetus may be due to an active placental transport mechanism. Maternal serum folate level correlated positively with that of umbilical cord blood, showing that folate concentration of umbilical cord blood is affected by maternal status. There was no significant correlation between the serum folate levels in maternal-umbilical cord blood and the pregnancy outcomes.(Korean J Nutrition 33(8) : 840-847, 2000)
Anemia in women during pregnancy and after delivery has been known to affect the mother, the fetus, and the infant's growth and health status. Studies examining, changes in iron and folate status associated with anemia during pregnancy and during pregnancy, and those supplements are stopped after postpartum. However, the effects of those have not been clearly determined in pregnant and lactating Korea women. Therefore, this study was performed to determine the changes in maternal iron and folate status during pregnancy and six months after delivery longitudinally in six pregnant women who consumed supplements from 20 wk to delivery. We concluded that the iron status deteriorated during pregnancy and especially was weak in the third trimester, but had a tendency to recovery after delivery. On the other hand, the folate status deteriorated in the first and second trimester and was good in the third trimester, but had a tendency to decrease after delivery. These results suggested that the iron status was not improved despite consuming total iron supplements of 50 mg/day through diets and supplements during the second half of the pregnancy. On the other hand, the folate status improved at the end of pregnancy by consuming folate supplements of a total of 800 mg/day through diets and supplements. However, folate status was poor in the first half of the pregnancy, and the tendency of folate status to decrease during postpartum was advanced. At the point in which iron and therefore supplementation is essential. However, the effects of supplement intake time and intake dosage need to be verified and the nutritional status changes of postpartum women should be carefully monitored.
The purpose of this study was to evaluate the folate nutritional status of Korean pregnant women and to investigate the relation between folate levels of maternal-umbilical cord blood, placenta tissue, and pregnancy outcomes. The study subjects consisted of 25 pregnant women who have had normal term deliveries. Dietary folate intakes of the pregnants were estimated by semi quantitative frequency questionnaire and the serum and placenta tissue folate level was measured by microbiological analysis. The total folate intakes of the pregnant women was 655.6 ${\mu}$g/d, which was 131.1% of the Korean RDA for pregnants. Maternal serum folate level was 16.18ng/ml, which was significantly lower than that of umbilical cord blood (34.98ng/ml, p<0.05). Mean folate concentration of the placental tissue was 998.0ng/ml, which was the highest compared to maternal and umbilical cord serum level. Umbilical cord serum folate level and placental tissue folate level were highly influenced by maternal serum folate level. The umbilical cord folate levels of the infant group whose birth weight was higher than 3500g were significantly higher than the group whose birth weight was less than 3500g (p<0.05). The placental folate level was significantly higher in maternal group who showed desirable weight gain during pregnancy (11 - 14kg). In conclusion, the birth weigt was related to the umbilical cord folate level and the maternal weight gain was affected by the placental folate level.
Folate and Vitamin $B_{12}$ are essential nutrients important during pregnancy. This study was conducted to evaluate the folate and vitamin $B_{12}$ nutritional status of Korean pregnant women and to investigate the relationship between maternalumbilical cord serum folate and vitamin B12 levels and pregnancy outcomes. Dietary intakes of the pregnant women were estimated by 24 hour-recall (3 times). Serum folate and vitamin B12 levels in maternal blood and umbilical cord of 27 pregnant women at 1'st-, 2'nd-, 3'rd-trimester and delivery were measured by RIA (radioimmuno assay), respectively. Means of folate and vitamin $B_{12}$ intake were $283.53\pm58.01{\mu}g/day\;and\; 2.99\pm1.32mg/day$, respectively. Maternal mean serum folate levels of the trimester and delivery were $9.75\pm3.60ng/ml,\;10.46\pm4.63ng/ml,\;10.71\pm4.14ng/ml\;and\;15.05\pm7.04ng/ml$. Those maternal levels were significantly lower than that of umbilical cord blood $(23.99\pm9.42ng/ml)$. Serum vitamin $B_{12}$ levels of maternal trimester and delivery were $479.07\pm137.56 pg/ml,\;310.96\pm137.56pg/ml,\;308.22\pm74.65pg/ml,\;and\;295.67\pm93.36pg/ml$, which were significantly lower than those of umbilical cord blood $(500.13\pm185.60ng/ml)$. This finding indicates that the uptake of folate and vitamin $B_{12}$ in the fetus may be due to an active placental transport mechanism. Maternal serum level correlated positively with those of umbilical cord blood, showing that folate and vitamin $B_{12}$ concentration of umbilical cord blood might be affected by maternal status. There was no significant correlation between the serum folate levels in maternal-umbilical cord blood and the pregnancy outcomes. However, maternal vitamin $B_{12}$ level at l'st trimester was significant positive correlation between the gestational age except for birth weight and weight gain.
Myelin basic protein (MBP), a major structural protein of the myelin, is thought to be important for the maintenance of myelin in the central nervous system (CNS). We investigated the effect of maternal folic acid nutritional status on the folate level and the synthesis of MBP in the offspring. In order to test this hypothesis, female Sprague-Dawley rats were fed either folic acid sufficient (8 mg/kg diet) or deficient (0 mg/kg diet) diet from 2 wks prior to the mating throughout the entire pregnancy, lactation and weaning period. We examined plasma folate level by the radioimmunoassay and homocysteine level by HPLC, respectively. The MBP expression was measured by the western blot analysis. The maternal folic acid deficiency decreased plasma folate level with a concomitant increase in plasma homocysteine level in their offspring. The maternal folic acid deficiency decreased hepatic levels of SAM and SAM/SAH ratio with a concomitant increase in hepatic levels of SAH and the MBP expression of spinal cord in their offspring at 7 wks of age. These results suggest that maternal folic acid nutritional status affect plasma folate and homocysteine level in their offspring. Moreover, the maternal folic acid deficiency mi호t inhibit the MBP expression of the spinal cord and disrupt many other vital CNS reactions in their offspring.
Journal of the Korean Society of Food Science and Nutrition
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v.33
no.2
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pp.331-338
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2004
Folate nutrition in early pregnancy is crucial in order to prevent neural tube defects (NTDs) in the fetus and maternal folate deficiency in late pregnancy If the influencing factors on maternal folate status are identified we may be able to detect the women at most risk of folate deficiency. This study intends to determine folate intakes, assess the levels of serum folate, erythrocyte folate, and plasma homocysteine, and reveal theinfluencing factors on maternal folate status in early pregnancy. A total of 151 healthy women in their first trimester volunteered for this study. The average length of gestation period was 9.1$\pm$ 2.3 weeks and seventy subjects were primipara. They consumed 1599$\pm$589 ㎉/day of energy and 230.8$\pm$145.2 $\mu\textrm{g}$/day of folate. This represented 72.5% and 46.2% of the Korean RDA respectively for pregnant women in the first half of Pregnancy. Results show that they consume less folate and energy due to morning sickness. Morning sickness correlated negatively with the intakes of energy, folate, ana Kimchi also. Their levels of serum folate, erythrocyte folate, and plasma homocysteine were 5.5$\pm$1.9 ng/mL, 266.6$\pm$75.0 ng/mL, and 7.0$\pm$1.8 $\mu$mol/L, respectively. Results indicate that 7.8% were deficient and 60.3% were borderline deficient in serum folate, 4.3% were deficient in erythrocyte folate, however, all had normal levels of plasma homocysteine. Results indicate that the folate status was not poor Contributing factors influencing serum folate concentrations ($R^2$= 0.724, p = 0.0001) were self-reported health status (+), folate intake (+), age (-), length of gestation (-), and homocysteine levels (-). Factors influencing erythrocyte folate concentrations ($R^2$ = 0.570, p = 0.0029) were the infant birth height of the last pregnancy (+), energy intake (+), age (-), plasma homocysteine concentration (-), and education level (-). Factors influencing plasma homocysteine concentrations ($R^2$= 0.450, p = 0.0051) were income level (+), prepregnancy weight (+), serum folate concentration (-), and the infant birth weight of the last pregnancy (-). These results indicate that pregnant women are likely to have a folate deficiency if they are in poor health status, having a history of delivering small infant and low energy and/or folate intake, and/or are older. And folate status is likely to decline as pregnancy progresses.
The purpose of this study were to determine the folate status of pregnant women living in kwangju, Korea and to assess the relationships between folate status and pregnancy outcome. Eighty-one women took part in the study: 26 in their first trimester of pregnancy, 23 in the second, and 32 in the final trimester. The folate intake data both from their diets and supplementasage was obtained using a 24-hour recall method and by measuring the use of supplements. Folate levels of serum and erythrocytes were determined by a microbiological assay using Lactovacillus casei(ATTC 7469) as the test organism. A series of determinations for pregnancy outcome was conducted, including birth weight, length, Apgar score at 5 min after birth, and gestational period. The dietary folate intake in each trimester was 118$\pm$85, 148$\pm$117, and 137$\pm$69ug/d, respectively. All levels were far below the Korean recommended diet allowances(RDA)for folate. Eighty-four percent of the subjects consumed supplemental folate after the 20th week of pregnancy until delivery. the supplemental folate intakes in the second and third trimester were 651$\pm$142 and 688$\pm$150ug/d, respectively. Therefore, the women who took folate supplements consumed more folate than the RDA. Serum folate levels for each trimester were 9.0$\pm$3.8, 11.4$\pm$6.0, and 16.3$\pm$11.0ng/ml respectively, greadually increasing as the pregnancy progressed; the serum folate level in the third trimester was significantly higher(p<0.05) than that in first trimester. The erythrocyte folate concentrations in each trimester were recorded as 369.8$\pm$108.8, 396.2$\pm$107.5, and 420$\pm$7 162.6ng/ml respectively. There was no significant differences among the erythrocyte folate concentrations unlike the serum folate levels. There was no significant difference among the erythrocyte folate concentrations unlike the serum folate levels. There was no signifcant correlation between trimester to be important in maintaining adequate folate status, however these results imply that the serum and erythrocyte folate levels were adequate to support the growth of the fetus.
Fragile histidine triad (FHIT) is a suppressor gene related to cervical cancer through CpG island hypermethylation. Folate is a water-soluble B-vitamin and an important cofactor in one-carbon metabolism. It may play an essential role in cervical lesions through effects on DNA methylation. The purpose of this study was to observe effects of folate and FHIT methylation and HPV 16 on cervical cancer progression. In this study, DNA methylation of FHIT, serum folate level and HPV16 status were measured using methylation-specific polymerase chain reaction (MSP), radioimmunoassay (RIA) and polymerase chain reaction (PCR), respectively, in 310 women with a diagnosis of normal cervix (NC, n=109), cervical intraepithelial neoplasia (CIN, n=101) and squamous cell carcinoma of the cervix (SCC, n=101). There were significant differences in HPV16 status (${\chi}^2=36.64$, P<0.001), CpG island methylation of FHIT (${\chi}^2=71.31$, P<0.001) and serum folate level (F=4.57, P=0.011) across the cervical histologic groups. Interaction analysis showed that the ORs only with FHIT methylation (OR=11.47) or only with HPV 16 positive (OR=4.63) or with serum folate level lower than 3.19ng/ml (OR=1.68) in SCC group were all higher than the control status of HPV 16 negative and FHIT unmethylation and serum folate level more than 3.19ng/ml (OR=1). The ORs only with HPV 16 positive (OR=2.58) or with serum folate level lower than 3.19ng/ml (OR=1.28) in CIN group were all higher than the control status, but the OR only with FHIT methylation (OR=0.53) in CIN group was lower than the control status. HPV 16 positivity was associated with a 7.60-fold increased risk of SCC with folate deficiency and with a 1.84-fold increased risk of CIN. The patients with FHIT methylation and folate deficiency or with FHIT methylation and HPV 16 positive were SCC or CIN, and the patients with HPV 16 positive and FHIT methylation and folate deficiency were all SCC. In conclusion, HPV 16 infection, FHIT methylation and folate deficiency might promote cervical cancer progression. This suggests that FHIT may be an effective target for prevention and treatment of cervical cancer.
Elevated maternal plasma homocysteine concentrations have been associated with adverse pregnancy outcomes. Serum homocysteine levels may be affected by the MTHFR genotypes and the nutritional status of B vitamins including vitamin $B_2,\;B_6$, folate and vitamin $B_{12}$. We investigated whether postnatal growth measurements were influenced by maternal MTHFR genotypes and their mid-pregnancy serum vitamin B and homocysteine levels. In 130 pregnant women of 24-28 wks of gestation, the MTHFR genotypes, serum B vitamins and homocysteine concentrations were analyzed. Physical growth status was assessed in their offsprings by measuring height, weight, and head and chest circumferences from birth up to 24 months. Serum homocysteine levels were higher in the subjects with T/T genotype than those with the C/T or C/C. Heights and head and chest circumferences of offsprings from the T/T mothers were significantly lower than those from the C/C or C/T mothers only when the serum homocysteine levels were above the median. The mean height of offsprings from the T/T mothers was significantly lower than those from the C/C and C/T mothers. The mean weight and head circumferences of offsprings born from the mothers whose mid-term pregnancy PLP levels were in the lowest quartile was significantly lower than those from mothers in the highest quartile. Heights and head circumferences of offsprings from the T/T mothers were significantly lower than those from the C/C or C/T mothers only when the serum FAD levels were in the lowest quartile. These results suggest that postnatal growth up to 24 months may be influenced by the maternal C677T MTHFR genotypes, and mid-pregnancy serum homocysteine and vitamin B status.
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