Yaremco Elyse, Inglis Angela, Innis Sheila M, Hippman Catriona, Carrion Prescilla, Lamers Yvonne, Honer William G, Austin Jehannine
Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada.
Birth Defects Res A Clin Mol Teratol. 2013 Jun;97(6):416-20. doi: 10.1002/bdra.23144. Epub 2013 Jun 13.
Maternal folate supplementation reduces offspring risk for neural tube defects (NTDs) and other congenital abnormalities. Maternal red blood cell (RBC) folate concentrations of >906 nmol/L have been associated with the lowest risk of having a neural tube defect affected pregnancy. Mood disorders (e.g., depression, bipolar disorder) are common among women and can be associated with folate deficiency. Thus, pregnant women with histories of mood disorders may be prone to RBC folate levels insufficient to provide optimal protection against neural tube defects. Although previous studies have assessed RBC folate concentrations in pregnant women from the general population, none have looked specifically at a group of pregnant women who have a history of a mood disorder.
We collected data about RBC folate concentrations and folic acid supplement intake during early pregnancy (<161 days gestation) from n = 24 women with histories of mood disorders. We also collected information about offspring congenital abnormalities and birth weight.
Among women with histories of mood disorders, the mean RBC folate concentration was 674 nmol/L (range, 362-1105 nmol/L). Only 12.5% (n = 3) of the women had RBC folate concentrations >906 nmol/L, despite all participants reporting current daily use of folic acid supplements. Data regarding offspring were available for 22 women: birth weights ranged from 2296 g to 4819 g, and congenital abnormalities were identified in two (hypoplastic left heart, annular pancreas).
Data from this exploratory case series suggest a need for future larger scale controlled studies investigating RBC folate concentrations in early pregnancy and offspring outcomes among women with and without histories of mood disorders.
孕期补充叶酸可降低后代患神经管缺陷（NTDs）及其他先天性异常的风险。孕妇红细胞（RBC）叶酸浓度>906 nmol/L时，胎儿患神经管缺陷的风险最低。情绪障碍（如抑郁症、双相情感障碍）在女性中很常见，且可能与叶酸缺乏有关。因此，有情绪障碍病史的孕妇可能容易出现红细胞叶酸水平不足，无法为预防神经管缺陷提供最佳保护。尽管先前的研究评估了普通人群中孕妇的红细胞叶酸浓度，但尚无研究专门针对有情绪障碍病史的孕妇群体。
我们收集了n = 24名有情绪障碍病史的女性在孕早期（妊娠<161天）的红细胞叶酸浓度和叶酸补充剂摄入量数据。我们还收集了有关后代先天性异常和出生体重的信息。
在有情绪障碍病史的女性中，红细胞叶酸浓度平均为674 nmol/L（范围为362 - 1105 nmol/L）。尽管所有参与者均报告当前每日服用叶酸补充剂，但只有12.5%（n = 3）的女性红细胞叶酸浓度>906 nmol/L。有22名女性提供了后代的数据：出生体重范围为2296 g至4819 g，两名后代被诊断出先天性异常（左心发育不全、环状胰腺）。
这个探索性病例系列的数据表明，未来需要进行更大规模的对照研究，以调查有和没有情绪障碍病史的女性在孕早期的红细胞叶酸浓度及后代结局。
