Shanghai Preconception Cohort (SPCC) for the association of periconceptional parental key nutritional factors with health outcomes of children with congenital heart disease: a cohort profile
Abstract:PurposeThe Shanghai Preconception Cohort (SPCC) was initially established to investigate the associations of parental periconceptional nutritional factors with congenital heart disease (CHD) but has further analysed child growth and development and paediatric diseases.ParticipantsPreparing-for-pregnancy couples who presented at Shanghai preconception examination clinics and early-pregnancy women before 14 gestational weeks were enrolled to comprise the periconceptional baseline study population. General charac… Show more
“…This study was conducted within the Shanghai Preconception Cohort (SPCC; NCT02737644) that aims to investigate the associations between periconceptional maternal key nutrients and neonatal health outcomes, including congenital heart disease ( 20 ). Two subcohorts consisting of 938 and 458 subjects were derived for studying the associations of RBC folate with congenital heart diseases and infant atopic dermatitis.…”
Section: Methodsmentioning
confidence: 99%
“…The details of blood sample collection and nutritious biomarker measurements were described elsewhere ( 20 ). Briefly, the remaining blood samples after routine examinations at the first antenatal visit were collected by trained staff.…”
To investigate the association of folate and vitamin B 12 in early pregnancy with gestational diabetes mellitus (GDM) risk.
RESEARCH DESIGN AND METHODSThe data of this study were from a subcohort within the Shanghai Preconception Cohort Study. We included pregnancies with red blood cell (RBC) folate and vitamin B 12 measurements at recruitment (between 9 and 13 gestational weeks) and those with three samples available for glucose measurements under an oral glucose tolerance test. GDM was diagnosed between 24 and 28 weeks' gestation. Odds ratio (OR) and 95% CI of having GDM was used to quantify the association.
RESULTSA total of 1,058 pregnant women were included, and GDM occurred in 180 (17.01%). RBC folate and vitamin B 12 were significantly higher in pregnancies with GDM than those without GDM (P values were 0.045 and 0.002, respectively) and positively correlated with 1-h and 2-h serum glucose. Daily folic acid supplementation in early pregnancy increases the risk of GDM; OR (95% CI) was 1.73 (1.19-2.53) (P 5 0.004). Compared with RBC folate <400 ng/mL, pregnancies with RBC folate ‡600 ng/mL were associated with ∼1.60-fold higher odds of GDM; the adjusted OR (95% CI) was 1.58 (1.03-2.41) (P 5 0.033). A significant trend of risk effect on GDM risk across categories of RBC folate was observed (P trend 5 0.021). Vitamin B 12 was significantly associated with GDM risk (OR 1.14 per 100 pg/mL; P 5 0.002). No significant association of serum folate and percentile ratio of RBC folate/vitamin B 12 with GDM was observed.
CONCLUSIONSHigher maternal RBC folate and vitamin B 12 levels in early pregnancy are significantly associated with GDM risk, while the balance of folate/vitamin B 12 is not significantly associated with GDM.As one of the most common pregnancy complications, gestational diabetes mellitus (GDM) affects ;17% of pregnancies worldwide (1). In China, ;2.9 million pregnant women suffer from this disorder (2). GDM has long-term adverse outcomes in both mothers and offspring (3). Despite its serious complications, the diagnosis of GDM is
“…This study was conducted within the Shanghai Preconception Cohort (SPCC; NCT02737644) that aims to investigate the associations between periconceptional maternal key nutrients and neonatal health outcomes, including congenital heart disease ( 20 ). Two subcohorts consisting of 938 and 458 subjects were derived for studying the associations of RBC folate with congenital heart diseases and infant atopic dermatitis.…”
Section: Methodsmentioning
confidence: 99%
“…The details of blood sample collection and nutritious biomarker measurements were described elsewhere ( 20 ). Briefly, the remaining blood samples after routine examinations at the first antenatal visit were collected by trained staff.…”
To investigate the association of folate and vitamin B 12 in early pregnancy with gestational diabetes mellitus (GDM) risk.
RESEARCH DESIGN AND METHODSThe data of this study were from a subcohort within the Shanghai Preconception Cohort Study. We included pregnancies with red blood cell (RBC) folate and vitamin B 12 measurements at recruitment (between 9 and 13 gestational weeks) and those with three samples available for glucose measurements under an oral glucose tolerance test. GDM was diagnosed between 24 and 28 weeks' gestation. Odds ratio (OR) and 95% CI of having GDM was used to quantify the association.
RESULTSA total of 1,058 pregnant women were included, and GDM occurred in 180 (17.01%). RBC folate and vitamin B 12 were significantly higher in pregnancies with GDM than those without GDM (P values were 0.045 and 0.002, respectively) and positively correlated with 1-h and 2-h serum glucose. Daily folic acid supplementation in early pregnancy increases the risk of GDM; OR (95% CI) was 1.73 (1.19-2.53) (P 5 0.004). Compared with RBC folate <400 ng/mL, pregnancies with RBC folate ‡600 ng/mL were associated with ∼1.60-fold higher odds of GDM; the adjusted OR (95% CI) was 1.58 (1.03-2.41) (P 5 0.033). A significant trend of risk effect on GDM risk across categories of RBC folate was observed (P trend 5 0.021). Vitamin B 12 was significantly associated with GDM risk (OR 1.14 per 100 pg/mL; P 5 0.002). No significant association of serum folate and percentile ratio of RBC folate/vitamin B 12 with GDM was observed.
CONCLUSIONSHigher maternal RBC folate and vitamin B 12 levels in early pregnancy are significantly associated with GDM risk, while the balance of folate/vitamin B 12 is not significantly associated with GDM.As one of the most common pregnancy complications, gestational diabetes mellitus (GDM) affects ;17% of pregnancies worldwide (1). In China, ;2.9 million pregnant women suffer from this disorder (2). GDM has long-term adverse outcomes in both mothers and offspring (3). Despite its serious complications, the diagnosis of GDM is
“…This prospective cohort was derived from the ongoing Shanghai Preconception Cohort Study (SPCC: NCT02737644) that aims to investigate the associations of parental periconceptional nutrition factors with congenital heart disease, childhood growth and development, as well as subsequent paediatric diseases. 11 In this study, pregnant women recruited from prenatal care hospitals who had LFB measurements in early pregnancy (between 9 and 13 weeks of gestation) and an oral glucose tolerance test (OGTT) at completion of pregnancy with three glucose measurements for GDM diagnosis between 24 and 28 weeks of gestation were eligible for this study. Those with a history of type 2 diabetes or taking hypoglycemic agents or with diagnosed liver disease were excluded.…”
Section: Study Populationmentioning
confidence: 99%
“…9,10 It is still unclear whether obesity could modify the association between GGT and GDM. With the advantage of our larger prospective cohort, 11 we aim to elucidate whether the associations of maternal LFBs with GDM are independent of overweight.…”
Objective: To evaluate whether the associations of maternal liver dysfunction and liver function biomarkers (LFBs) with gestational diabetes mellitus (GDM) are independent of overweight.
Design: Prospective cohort study.Methods: A sub-cohort of pregnant women with seven LFBs examined at 9-13 weeks of gestation and with complete GDM evaluation at mid-gestation were extracted from the prospective Shanghai Preconception Cohort Study. Associations of liver dysfunction, defined as having any elevated LFB levels, and individual LFB levels with GDM incidence were assessed by adjusting body mass index and other covariates in the multivariable logistic regression model. Odds ratios (ORs) and 95% CI were reported.
“…Heart defects are among the most common congenital defects in humans, and low concentrations of folic acid, hyperhomocysteinaemia, and MTHFR polymorphisms are also very common in children with congenital heart defects and their mothers. The relationship between mutations of the MTHFR gene and the occurrence of congenital heart defects in children has also been proven [3,4]. Should we also consider increasing the standard dose of 400 µg of folic acid for patients who have given birth to a child with a congenital heart defect, analogous to the recommendations prepared for families with a positive history of NTD (Table I) [1]?…”
Should we pay special attention to the supplementation for patients with a congenital foetal heart defect, whether they require special care, assuming that each subsequent pregnancy should be planned? Should patients with cardiac problems in their current pregnancy make any changes to their regular supplementation? In our short report we would like to discuss the issues of supplementation, especially folates and vitamin D, from the perspective of prenatal cardiology and specific problems affecting postnatal prognosis, paying special attention to the prevention of COVID-19 and pre-eclampsia during pregnancy. We propose that our observations be considered concerning mainly rich supplementation with folic acid as well as vitamin D for patients with cardiac problems in the foetus.
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