Folic acid supplementation in pregnancy and implications in health and disease.

Subit Barua,Salomon Kuizon,Mohammed A Junaid

doi:10.1186/s12929-014-0077-z

Abstract

Maternal exposure to dietary factors during pregnancy can influence embryonic development and may modulate the phenotype of offspring through epigenetic programming. Folate is critical for nucleotide synthesis, and preconceptional intake of dietary folic acid (FA) is credited with reduced incidences of neural tube defects in infants. While fortification of grains with FA resulted in a positive public-health outcome, concern has been raised for the need for further investigation of unintended consequences and potential health hazards arising from excessive FA intakes, especially following reports that FA may exert epigenetic effects. The objective of this article is to discuss the role of FA in human health and to review the benefits, concerns and epigenetic effects of maternal FA on the basis of recent findings that are important to design future studies.

Highlights

The emerging view of epidemiological studies indicates the importance of the intrauterine environment in early fetal development
History and impact of folic acid on public health A possible relationship between apparent folate deficiency and increased incidence of prematurity was suggested as early as 1944 by Callender [26]. This was later confirmed by Gatenby and Lillie [27], and in 1960s, Richard Smithells and Elizabeth Hibbard hypothesized that the under nutrition or impaired folate status could be an important factor in the origin of Neural tube defect (NTD) based on significant observations, that women who had given birth to the children with birth defects i.e. anencephaly and spinabifida have an altered formiminoglutamic acid compared to the women with unaffected children [28]
The central role of this coenzyme is to modulate the metabolic pathway by accepting or donating one-carbon units [44]. Key genes in this pathway that are involved in transferring the methyl group to homocysteine, and have been most extensively studied include methylenetetrahydrofolate reductase (MTHFR), methionine synthase reductase (MTRR), reduced folate carrier (RFC), along with vitamin B12- dependent methionine synthase (MTR) [45]

Summary

Introduction

The emerging view of epidemiological studies indicates the importance of the intrauterine environment in early fetal development. History and impact of folic acid on public health A possible relationship between apparent folate deficiency and increased incidence of prematurity was suggested as early as 1944 by Callender [26] This was later confirmed by Gatenby and Lillie [27], and in 1960s, Richard Smithells and Elizabeth Hibbard hypothesized that the under nutrition or impaired folate status could be an important factor in the origin of NTD based on significant observations, that women who had given birth to the children with birth defects i.e. anencephaly and spinabifida have an altered formiminoglutamic acid compared to the women with unaffected children [28]. The central role of this coenzyme is to modulate the metabolic pathway by accepting or donating one-carbon units [44] Key genes in this pathway that are involved in transferring the methyl group to homocysteine, and have been most extensively studied include methylenetetrahydrofolate reductase (MTHFR), methionine synthase reductase (MTRR), reduced folate carrier (RFC), along with vitamin B12- dependent methionine synthase (MTR) [45]. In the future there is definitely a need of global collaboration to accumulate scientific evidence from a clinical perspective, and to interpret these intervention studies and potential effect in large cohorts

Conclusion

33. MRC Vitamin Study Research Group

40. Fowler B

44. Stanger O

Findings

79. Kallen B