• About Us
    • Contact Us
    • Login
    • ObGFirst
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • COVID-19
About Us Contact Us Login ObGFirst
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • COVID-19
Grand Rounds

Association Between Periconception Maternal Folate and Risk for Congenital Heart Disease in Offspring

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • Folic acid supplementation prior to conception may reduce the risk of congenital heart disease (CHD) in offspring
  • Data is limited regarding association between maternal red blood cell (RBC) folate and subsequent CHD risk
  • Chen et al. (Annals of Internal Medicine, 2022) quantified the association between periconception maternal RBC folate and offspring CHD risk

METHODS:

  • Prospective, nested, case–control study and 1-sample Mendelian randomization
    • Data derived from the SPCC (Shanghai Preconception Cohort)
  • Participants
    • All mothers of offspring with CHD and individually matched mothers of unaffected offspring
  • Exposures
    • Maternal RBC folate, measured before or at early pregnancy
  • Study design
    • Odds ratios (ORs) were estimated using logistic regression after adjustment for covariates
    • Mendelian randomization was done using the MTHFR C677T as the genetic instrument
  • Primary outcome
    • Offspring CHD

RESULTS:

  • Case patients: 197 mothers | Controls: 788
  • Median maternal RBC folate concentrations
    • Cases: 714 (IQR, 482 to 1008) nmol/L
    • Controls: 788 (IQR, 557 to 1094) nmol/L
  • Maternal RBC folate concentrations were inversely associated with offspring CHD
    • aOR per 100 nmol/L: 0.93 (95% CI, 0.89 to 0.99)
  • Periconception maternal RBC folate of ≥906 nmol/L was associated with lower risk for CHD among offspring
    • aOR 0.61 (95% CI, 0.40 to 0.93)
  • Mendelian randomization showed that each 100-nmol increase in maternal RBC folate concentrations was significantly associated with reduced offspring CHD risk
    • OR 0.75 (95C CI, 0.61 to 0.92)

CONCLUSION:

  • A higher maternal RBC folate concentration early in pregnancy is associated with a reduced risk for congenital heart disease among offspring
  • The authors state

We propose that target RBC folate levels higher than those currently recommended for NTD prevention be considered for primary CHD prevention

For prevention of offspring CHD, the authors argue that target folate supplement levels may need to be higher than they currently are, and this presents an avenue for further study

Learn More – Primary Sources:

Periconception Red Blood Cell Folate and Offspring Congenital Heart Disease

Want to stay on top of key guidelines and research papers?

ObGFirst® – Try It Free! »

image_pdfFavoriteLoadingFavorite
< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

Epilepsy in Pregnancy: Is Prenatal Dietary Folate Sufficient to Improve Cognitive Outcomes in Offspring?
Does Folic Acid Supplementation Before Pregnancy Reduce Risk of Gestational Diabetes?
What is the Impact of Folic Acid Supplementation on Postnatal Brain Development

Sections

  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • COVID-19

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site