Silva Carla, Keating Elisa, Pinto Elisabete
Faculty of Medicine of University of Porto, Porto, Portugal.
Department of Biomedicine - Biochemistry Unit, Faculty of Medicine of University of Porto, Porto, Portugal.
Porto Biomed J. 2017 Nov-Dec;2(6):315-332. doi: 10.1016/j.pbj.2017.05.006. Epub 2017 Jul 12.
Associations between FA supplementation in pregnancy and effects on offspring's NTDs, allergy/respiratory problems, cancer and behaviour problems as been studied.There is growing concern about the effects of excessive FA supplementation, whether in terms of doses or times of exposure.FA supplementation in the periconceptional period is protective against NTDs while in later periods it could be deleterious.A daily dose of 0.4 mg FA in the periconceptional period seems to be effective and safe.
Maternal folic acid (FA) supplementation is one of the most popular nutritional interventions during pregnancy for its protective effect against neural tube defects (NTDs).The purposes of this review are: (a) to gather the current evidence regarding supplementation of maternal diet with FA and (b) to problematize the available literature in terms of dosages, critical temporal windows, and its potential benefits and risks.The expression (pregnancy OR fetus OR offspring OR mother) AND ("folic acid" AND supplementation) was searched on PubMed database, filtering for articles published from 2005 to 2014. Publications referring to FA supplementation during the periconceptional period or pregnancy in which there was a conclusion about the effects of isolated FA supplementation on pregnant woman, pregnancy or offspring were included. Of the initial 1182 papers, 109 fulfilled the inclusion criteria.The majority of the publications reported FA supplementation outcomes on offspring's health, with emphasis in NTDs, allergy/respiratory problems, cancer and behaviour problems. Some inconsistency is observed on the impact of FA supplementation on different outcomes, except for NTDs. It is also visible an increased concern about the impact of excessive supplementation, either in terms of doses or exposure's duration.In conclusion, there is a growing interest in FA supplementation issues. The protective effect of FA supplementation over NTDs has been confirmed, being the periconceptional period a critical window, and it is frequently suggested that allergy/respiratory outcomes arise from (excessive) FA supplementation particularly later in pregnancy. Further research on critical doses and time of exposure should be conducted.
已对孕期补充叶酸（FA）与对后代神经管缺陷（NTDs）、过敏/呼吸问题、癌症和行为问题的影响之间的关联进行了研究。人们越来越关注过量补充FA的影响，无论是从剂量还是暴露时间方面来看。孕期补充FA在受孕前阶段对预防NTDs有保护作用，而在后期可能有害。受孕前阶段每日补充0.4毫克FA似乎是有效且安全的。
孕期补充母体叶酸（FA）是孕期最常见的营养干预措施之一，因其对神经管缺陷（NTDs）有保护作用。本综述的目的是：（a）收集有关在母体饮食中补充FA的当前证据，以及（b）从剂量、关键时间窗及其潜在益处和风险方面对现有文献提出质疑。在PubMed数据库中搜索了表达式（怀孕或胎儿或后代或母亲）与（“叶酸”与补充），筛选出2005年至2014年发表的文章。纳入了提及受孕前阶段或孕期补充FA且有关于单独补充FA对孕妇、怀孕或后代影响结论的出版物。在最初的1182篇论文中，109篇符合纳入标准。大多数出版物报告了补充FA对后代健康的结果，重点是NTDs、过敏/呼吸问题、癌症和行为问题。除NTDs外，在补充FA对不同结果的影响方面观察到一些不一致之处。在过量补充的影响方面，无论是剂量还是暴露持续时间，也都明显受到更多关注。总之，人们对补充FA问题的兴趣日益增加。补充FA对NTDs的保护作用已得到证实，受孕前阶段是关键窗口，并且经常有人认为过敏/呼吸结果尤其在孕期后期是由（过量）补充FA引起的。应进一步研究关键剂量和暴露时间。
