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Association of prenatal folate status with early childhood wheeze and atopic dermatitis.
Pediatr Allergy Immunol. 2018 03; 29(2):144-150.PA

Abstract

BACKGROUND

Prenatal folic acid supplementation is recommended to prevent birth defects. Some foods are fortified in the USA to ensure sufficient intake among reproductive-aged women. However, high prenatal folate exposure may be a risk factor for childhood atopic diseases. We investigated associations between prenatal folate and early childhood wheeze and atopic dermatitis in a US cohort.

METHODS

We studied 858 mother-child dyads, enrolled prenatally. Folate was measured in 2nd and 3rd trimester maternal plasma. Parents reported current wheeze (previous 12 months) and healthcare provider diagnosis of atopic dermatitis at 3 years. We examined associations using logistic regression, modeling folate continuously and dichotomously (< or ≥20 ng/mL), a level often considered supraphysiologic.

RESULTS

Over half of women were African American and on Medicaid. Median (interquartile range) folate levels were 22.6 (15.9-30.0) and 23.1 (16.1-30.0) ng/mL for 2nd and 3rd trimesters, respectively. Current wheeze and atopic dermatitis were reported for 20.4% and 26.8% of children, respectively. Second trimester folate as a continuous exposure was not significantly associated with outcomes. Decreased odds of current wheeze were observed in children born to mothers who had 2nd trimester folate ≥20 ng/mL (adjusted odds ratios = 0.67, 95% confidence interval = 0.46, 0.97) compared to children with maternal levels <20 ng/mL. Third trimester folate was not associated with outcomes.

CONCLUSIONS

High plasma folate in mid-pregnancy was associated with decreased odds of current wheeze at age 3. Our findings do not support harmful effects of high prenatal folate levels on childhood atopic diseases in this setting.

Authors+Show Affiliations

Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. Division of General Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. Center for Asthma and Environmental Health Research, Vanderbilt University Medical Center, Nashville, TN, USA.Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA.Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. Division of General Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. Center for Asthma and Environmental Health Research, Vanderbilt University Medical Center, Nashville, TN, USA. Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida.Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. Division of General Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. Center for Asthma and Environmental Health Research, Vanderbilt University Medical Center, Nashville, TN, USA.Department of Nutritional Sciences, University of Alabama at Birmingham, Birmingham, AL, USA.Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA.Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. Division of General Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. Center for Asthma and Environmental Health Research, Vanderbilt University Medical Center, Nashville, TN, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

29168294

Citation

Roy, A, et al. "Association of Prenatal Folate Status With Early Childhood Wheeze and Atopic Dermatitis." Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology, vol. 29, no. 2, 2018, pp. 144-150.
Roy A, Kocak M, Hartman TJ, et al. Association of prenatal folate status with early childhood wheeze and atopic dermatitis. Pediatr Allergy Immunol. 2018;29(2):144-150.
Roy, A., Kocak, M., Hartman, T. J., Vereen, S., Adgent, M., Piyathilake, C., Tylavsky, F. A., & Carroll, K. N. (2018). Association of prenatal folate status with early childhood wheeze and atopic dermatitis. Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology, 29(2), 144-150. https://doi.org/10.1111/pai.12834
Roy A, et al. Association of Prenatal Folate Status With Early Childhood Wheeze and Atopic Dermatitis. Pediatr Allergy Immunol. 2018;29(2):144-150. PubMed PMID: 29168294.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of prenatal folate status with early childhood wheeze and atopic dermatitis. AU - Roy,A, AU - Kocak,M, AU - Hartman,T J, AU - Vereen,S, AU - Adgent,M, AU - Piyathilake,C, AU - Tylavsky,F A, AU - Carroll,K N, Y1 - 2017/12/19/ PY - 2017/11/17/accepted PY - 2017/11/24/pubmed PY - 2018/8/17/medline PY - 2017/11/24/entrez KW - asthma KW - atopic dermatitis KW - atopy KW - child KW - folate KW - folic acid KW - prenatal KW - wheeze SP - 144 EP - 150 JF - Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology JO - Pediatr Allergy Immunol VL - 29 IS - 2 N2 - BACKGROUND: Prenatal folic acid supplementation is recommended to prevent birth defects. Some foods are fortified in the USA to ensure sufficient intake among reproductive-aged women. However, high prenatal folate exposure may be a risk factor for childhood atopic diseases. We investigated associations between prenatal folate and early childhood wheeze and atopic dermatitis in a US cohort. METHODS: We studied 858 mother-child dyads, enrolled prenatally. Folate was measured in 2nd and 3rd trimester maternal plasma. Parents reported current wheeze (previous 12 months) and healthcare provider diagnosis of atopic dermatitis at 3 years. We examined associations using logistic regression, modeling folate continuously and dichotomously (< or ≥20 ng/mL), a level often considered supraphysiologic. RESULTS: Over half of women were African American and on Medicaid. Median (interquartile range) folate levels were 22.6 (15.9-30.0) and 23.1 (16.1-30.0) ng/mL for 2nd and 3rd trimesters, respectively. Current wheeze and atopic dermatitis were reported for 20.4% and 26.8% of children, respectively. Second trimester folate as a continuous exposure was not significantly associated with outcomes. Decreased odds of current wheeze were observed in children born to mothers who had 2nd trimester folate ≥20 ng/mL (adjusted odds ratios = 0.67, 95% confidence interval = 0.46, 0.97) compared to children with maternal levels <20 ng/mL. Third trimester folate was not associated with outcomes. CONCLUSIONS: High plasma folate in mid-pregnancy was associated with decreased odds of current wheeze at age 3. Our findings do not support harmful effects of high prenatal folate levels on childhood atopic diseases in this setting. SN - 1399-3038 UR - https://www.unboundmedicine.com/medline/citation/29168294/Association_of_prenatal_folate_status_with_early_childhood_wheeze_and_atopic_dermatitis_ L2 - https://doi.org/10.1111/pai.12834 DB - PRIME DP - Unbound Medicine ER -