Short interpregnancy intervals and unfavourable pregnancy outcome: role of folate depletion

There is no generally accepted explanation for the excess risk of adverse pregnancy outcome after short interpregnancy intervals. In this paper, we present a hypothesis that is both biologically plausible, empirically testable, and able to explain many observations. Maternal serum and erythrocyte co...

Full description

Saved in:
Bibliographic Details
Published in:The Lancet (British edition) 2001-12, Vol.358 (9298), p.2074-2077
Main Authors: Smits, Luc JM, Essed, Gerard GM
Format: Article
Language:English
Subjects:
Biological and medical sciences
Birth defects
Birth Intervals
Blood
Breastfeeding & lactation
Cell division
Defects
Dietary supplements
Diseases of mother, fetus and pregnancy
Energy balance
Erythrocytes
Female
Fetuses
Folic acid
Folic Acid Deficiency - blood
Folic Acid Deficiency - complications
Growth rate
Gynecology. Andrology. Obstetrics
Health risk assessment
Hematinics - blood
Homocysteine
Humans
Hypotheses
Intervals
Iron
Medical sciences
Metabolism
Micronutrients
Miscarriage
Neural tube defects
Nutrients
Offspring
Postpartum
Pregnancy
Pregnancy Outcome
Pregnancy. Fetus. Placenta
Premature birth
Prevention
Restoration
Risk factors
Socioeconomics
Statistical analysis
Supplements
Vitamin B
Vitamin deficiency
Vitamins
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:There is no generally accepted explanation for the excess risk of adverse pregnancy outcome after short interpregnancy intervals. In this paper, we present a hypothesis that is both biologically plausible, empirically testable, and able to explain many observations. Maternal serum and erythrocyte concentrations of folate decrease from the fifth month of pregnancy onwards and remain low for a fairly long time after delivery. Women who become pregnant before folate restoration is complete have a raised risk of folate insufficiency at the time of conception and during pregnancy. As a consequence, their offspring have higher risks of neural tube defects, intrauterine growth retardation, and preterm birth. We make several predictions based on our hypothesis and suggest ways of testing them empirically. The proposed mechanism implies, among other things, that postpartum supplementation with folic acid might prevent excess risk of unfavourable pregnancy outcome in women with short interpregnancy intervals.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(01)07105-7