Current results regarding the effect of folic acid (FA) supplement use on gestational hypertension (GH) and preeclampsia are limited and inconsistent. We aimed to investigate whether FA supplement use was associated with GH and preeclampsia. Participants from the Tongji Maternal and Child Health Cohort with information on periconceptional FA supplement use and diagnosis of GH/preeclampsia were included (n=4853). Robust Poisson regression was used to assess the association of FA supplement use and GH and preeclampsia. Among the 4853 participants in this study, 1161 (23.9%) and 161 (3.3%) women were diagnosed with GH and preeclampsia, respectively. The risk ratio of developing GH was higher in women who used ≥800 µg/d FA supplement from prepregnancy through midpregnancy than nonusers (risk ratio, 1.33 [1.08–1.65]). After adjusting for social-demographic, reproductive, lifestyle factors, family history of hypertension, other supplement use, and gestational weight gain, the adverse association remained significant (risk ratio, 1.32 [1.06–1.64]). Restricting the analysis among women with normal weight, without family history of hypertension, and without gestational diabetes mellitus, the positive FA-GH association still existed. We did not find any significant association between FA supplement use and preeclampsia regardless of adjustment. High-dose (≥800 µg/d) FA supplement use from prepregnancy through midpregnancy was associated with increased risk of GH. Attention should be given to avoid the potential risk of GH due to inappropriate FA supplement use in women who are planning or capable of pregnancy.
Manganese (Mn) intake has been found to be linked with risk of type 2 diabetes. However, the role of Mn in the development of gestational diabetes mellitus (GDM) remains to be investigated. This prospective study included pregnant women from the Tongji Maternal and Child Health Cohort. A total of 2327 participants with plasma specimens before 20 weeks were included. Among the pregnant women, 9.7% (225/2327) were diagnosed with GDM. After adjustment, pregnant women with the third and highest quartile of plasma Mn levels had 1.31-fold (RR, 2.31 [1.48, 3.61]) and 2.35-fold (RR, 3.35 [2.17, 5.17]) increased risk of GDM compared with those with the lowest quartile. A 1 standard deviation increment of ln-transformed plasma Mn levels (0.53 μg/L) was related to elevated risks of GDM with RRs of 1. 28 [1.17, 1.40]. The positive associations between Mn and GDM remained consistent in all the subgroups. The weighted quantile sum index was significantly related to GDM (RR, 1.60 [1.37, 1.86]). The contribution of Mn (58.69%) to the metal mixture index was the highest related to GDM. Higher plasma Mn levels were found to be linked with elevated fasting and 2 h post-load blood glucose. This study revealed relationships of higher plasma Mn levels in early pregnancy and increased risk of GDM, suggesting that though essential, excess Mn in the body might be a potential important risk factor for GDM.
Objectives To investigate the association between blood vanadium (V) concentrations in early pregnancy and blood lipid profiles and their implications on gestational diabetes mellitus (GDM). Methods We performed a prospective study of 2416 pregnant women from the Tongji Maternal and Child Health Cohort (TMCHC). Demographic characteristics and dietary intake were obtained by questionnaire, and an oral glucose tolerance test (OGTT) was conducted at 24–28 gestational weeks to diagnose GDM. V concentrations and lipid levels were determined by analysis of blood samples, which were collected before 20 gestational weeks, with the use of inductively coupled plasma mass spectrometry (ICP-MS) and commercial assay kits. Multiple linear regression and Logistic regression were used in our analysis. Results The median (inter quartile range) value of V concentrations of all pregnant women was 0.19 (0.24, 0.32) μg/L. After adjusting for demographic and dietary factors, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) and total cholesterol (TC) were correlated positively with blood concentrations of V (p for trend = 0.002 for LDL-C, p for trend = 0.006 for TG and p for trend = 0.003 for TC) while there was a significant negative correlation between high-density lipoprotein cholesterol (HDL-C) and V concentrations (p for trend < 0.001). In addition, V concentrations were significantly higher in women with GDM than those without GDM (median value: 0.26μg/L vs. 0.24μg/L, p < 0.001). After adjustment for potential confounders, for each one natural logarithmic unit increase in V concentrations, there was 42% [adjusted odds ratio (OR) = 1.42; 95% confidence interval (CI): 1.14, 1.77] increase in the risk of GDM. Women in the highest quartile for V had a 2.24-fold (95% CI: 1.43, 3.52) higher risk of GDM compared with women in the lowest quartile (p for trend = 0.002). Conclusions To our knowledge, this is the first research of associations between blood V levels during pregnancy and blood lipid profiles or GDM. Our study suggests that pregnant women with higher V exposure levels may have higher risks of dyslipidemia and GDM, either evaluated with or without adjustment of demographic information, dietary factors or other common trace elements’ concentrations. Funding Sources Received from the National Program on Basic Research Project of China (NO.2013FY114200) for Nianhong Yang.
Maternal gestational weight gain (GWG) is an important determinant of infant birthweight and having adequate total GWG has been widely recommended. However, the association of timing of GWG with birthweight remains controversial. We aimed to evaluate the association of timing of GWG with birthweight, especially among women with adequate total GWG. In a prospective cohort study, pregnant women’s weight was routinely measured during pregnancy, and their GWG was calculated for the 10 intervals: the first 13, 14–18, 19–23, 24–28, 29–30, 31–32, 33–34, 35–36, 37–38, and 39–40 weeks. Birthweight was measured and small- and large-for-gestational-age were assessed. Generalized linear models with Gaussian distribution and Poisson models were used to evaluate the associations of GWG with birthweight and birthweight outcomes after multivariate adjustment, respectively. Of the 5049 women, increased GWG in the first 30 weeks was associated with increased birthweight for male infants (birthweight increased by 63.91 (95% CI 28.64, 99.19), 105.07 (77.54, 132.61), 95.10 (65.18, 125.02), 70.31 (40.24, 100.39), and 73.59 (46.09, 101.08) g for 0.5 kg/wk increase in GWG during the first 5 intervals, respectively), and increased GWG in the first 28 weeks was associated with increased birthweight for females (birthweight increased by 47.99 (95% CI 9.85, 86.13), 81.12 (52.15, 110.08), 75.46 (46.52, 104.40), and 61.06 (32.18, 89.94) g for 0.5 kg/wk increase in GWG during the first 4 intervals, respectively). Among 1713 women with adequate total GWG, increased GWG percent between 14–23 weeks was associated with increased birthweight. Moreover, inadequate GWG between 14–23 weeks, compared with the adequate GWG, was associated with an increased risk of small-for-gestational-age (43 [13.7%] vs 42 [7.2%]; relative risk 1.83, 95% CI 1.21, 2.76). Timing of GWG may influence infant birthweight differentially, and women with inadequate GWG between 14–23 weeks may be at higher risk of delivering small-for-gestational-age infants, despite having adequate total GWG.
Objective To evaluate the association between patterns of gestational weight gain (GWG) and allergic diseases in offspring. Design Prospective cohort study. Setting Prenatal clinics in Wuhan, China. Population A cohort of 2546 mother and offspring pairs were enrolled before 16 weeks of gestation and followed up to 24 months postpartum. Methods Maternal body weights were measured regularly during pregnancy, and their GWG patterns were estimated using the growth mixture model. Robust Poisson models were used to evaluate relative risk (RR) and 95% CI after multivariable adjustment. Main outcome measures Offspring atopic allergy and allergic contact dermatitis were defined according to a physician's diagnosis reported by the mother, and food allergy was reported by the mother. Results Three GWG patterns were identified: 18.1% (461) of the women were described as pattern 1, characterised by rapid GWG earlier in pregnancy; 56.6% (1442) of the women were described as pattern 2, with steady GWG throughout pregnancy; and 25.3% (643) of the women was described as pattern 3, with rapid GWG later in pregnancy. By the age of 24 months, 360 (14.1%), 109 (4.3%) and 757 (29.7%) offspring had atopic allergy, allergic contact dermatitis or food allergy, respectively. Compared with women in GWG pattern 2, the RRs (95% CIs) among women in pattern 1 were 0.74 (0.55–0.99) for atopic allergy, 0.64 (0.36–1.15) for allergic contact dermatitis and 0.95 (0.81–1.12) for food allergy. Conclusions Maternal GWG pattern characterised by rapid GWG earlier in pregnancy was associated with a lower risk of atopic allergy in offspring.
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