Predictors of red cell folate level in women attempting pregnancy

Judith E. Brown, David R. Jacobs, Terryl Johnson Hartman, Geralyn M. Barosso, Jamie S. Stang, Myron D. Gross, Melanie A. Zeuske

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

Objective. - To identify predictors of red cell folate level in women attempting to become pregnant. Design. - Cohort study. Setting. - A health maintenance organization serving the Minneapolis-St Paul, Minn, area. Participants. - A total of 189 healthy, primarily white women aged 22 to 35 years enrolled in the Diana Project, a population-based prospective study of preconceptional and prenatal risks to reproductive outcomes. The sample represents 189 of 219 enrolled women who were sequentially selected from the total Diana Project sample to receive additional laboratory analyses. Main Outcome Measure. - Red cell folate level. Results. - Folic acid supplements, folic acid intake from fortified cereals, vitamin C supplements, and serum zinc level (inverse) were found to predict red cell folate levels. Previous research has shown that red cell folate levels higher than 906 nmol/L (400 ng/mL) may be optimal for the prevention of folate-responsive neural tube defects. For folic acid supplement users, folate intakes of 450 μg per day and higher corresponded to these protective levels of red cell folate. In nonusers of supplements, intakes of more than 500 μg of folate per day from foods and folic acid-fortified cereals may be needed to attain red cell folate levels higher than 906 nmol/L (400 ng/mL). Red cell folate levels higher than 906 nmol/L (400 ng/mL) were primarily found in women who took folic acid supplements. Only 1 in 4 women had red cell folate levels higher than 906 nmol/L (400 ng/mL), while 1 in 8 had red celt folate levels indicative of a negative folate balance. Addition of a daily, 400-μg folic acid supplement to the usual diet would result in red cell folate levels over 906 nmol/L (400 ng/mL) in a majority of women in this study. Conclusions. - Supplementation of diets of women of childbearing potential with 400 μg of folic acid per day would effectively raise red cell folate to levels associated with a low risk of folate-responsive neural tube defects. Protective levels of red cell folate may also be obtained by ample consumption of vegetables, fruits, and folic acid-fortified breakfast cereals. Efforts to increase folic acid supplement use and folate consumption among women of childbearing potential must go beyond fortification of refined cereal and grain products and reach women within all educational and income groups.

Original languageEnglish (US)
Pages (from-to)548-552
Number of pages5
JournalJournal of the American Medical Association
Volume277
Issue number7
StatePublished - Feb 19 1997

Fingerprint

Folic Acid
Pregnancy
Neural Tube Defects
Diet

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Brown, J. E., Jacobs, D. R., Hartman, T. J., Barosso, G. M., Stang, J. S., Gross, M. D., & Zeuske, M. A. (1997). Predictors of red cell folate level in women attempting pregnancy. Journal of the American Medical Association, 277(7), 548-552.
Brown, Judith E. ; Jacobs, David R. ; Hartman, Terryl Johnson ; Barosso, Geralyn M. ; Stang, Jamie S. ; Gross, Myron D. ; Zeuske, Melanie A. / Predictors of red cell folate level in women attempting pregnancy. In: Journal of the American Medical Association. 1997 ; Vol. 277, No. 7. pp. 548-552.
@article{a2fa2bd989ba4182a80bc265768c47de,
title = "Predictors of red cell folate level in women attempting pregnancy",
abstract = "Objective. - To identify predictors of red cell folate level in women attempting to become pregnant. Design. - Cohort study. Setting. - A health maintenance organization serving the Minneapolis-St Paul, Minn, area. Participants. - A total of 189 healthy, primarily white women aged 22 to 35 years enrolled in the Diana Project, a population-based prospective study of preconceptional and prenatal risks to reproductive outcomes. The sample represents 189 of 219 enrolled women who were sequentially selected from the total Diana Project sample to receive additional laboratory analyses. Main Outcome Measure. - Red cell folate level. Results. - Folic acid supplements, folic acid intake from fortified cereals, vitamin C supplements, and serum zinc level (inverse) were found to predict red cell folate levels. Previous research has shown that red cell folate levels higher than 906 nmol/L (400 ng/mL) may be optimal for the prevention of folate-responsive neural tube defects. For folic acid supplement users, folate intakes of 450 μg per day and higher corresponded to these protective levels of red cell folate. In nonusers of supplements, intakes of more than 500 μg of folate per day from foods and folic acid-fortified cereals may be needed to attain red cell folate levels higher than 906 nmol/L (400 ng/mL). Red cell folate levels higher than 906 nmol/L (400 ng/mL) were primarily found in women who took folic acid supplements. Only 1 in 4 women had red cell folate levels higher than 906 nmol/L (400 ng/mL), while 1 in 8 had red celt folate levels indicative of a negative folate balance. Addition of a daily, 400-μg folic acid supplement to the usual diet would result in red cell folate levels over 906 nmol/L (400 ng/mL) in a majority of women in this study. Conclusions. - Supplementation of diets of women of childbearing potential with 400 μg of folic acid per day would effectively raise red cell folate to levels associated with a low risk of folate-responsive neural tube defects. Protective levels of red cell folate may also be obtained by ample consumption of vegetables, fruits, and folic acid-fortified breakfast cereals. Efforts to increase folic acid supplement use and folate consumption among women of childbearing potential must go beyond fortification of refined cereal and grain products and reach women within all educational and income groups.",
author = "Brown, {Judith E.} and Jacobs, {David R.} and Hartman, {Terryl Johnson} and Barosso, {Geralyn M.} and Stang, {Jamie S.} and Gross, {Myron D.} and Zeuske, {Melanie A.}",
year = "1997",
month = "2",
day = "19",
language = "English (US)",
volume = "277",
pages = "548--552",
journal = "JAMA - Journal of the American Medical Association",
issn = "0002-9955",
publisher = "American Medical Association",
number = "7",

}

Brown, JE, Jacobs, DR, Hartman, TJ, Barosso, GM, Stang, JS, Gross, MD & Zeuske, MA 1997, 'Predictors of red cell folate level in women attempting pregnancy', Journal of the American Medical Association, vol. 277, no. 7, pp. 548-552.

Predictors of red cell folate level in women attempting pregnancy. / Brown, Judith E.; Jacobs, David R.; Hartman, Terryl Johnson; Barosso, Geralyn M.; Stang, Jamie S.; Gross, Myron D.; Zeuske, Melanie A.

In: Journal of the American Medical Association, Vol. 277, No. 7, 19.02.1997, p. 548-552.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Predictors of red cell folate level in women attempting pregnancy

AU - Brown, Judith E.

AU - Jacobs, David R.

AU - Hartman, Terryl Johnson

AU - Barosso, Geralyn M.

AU - Stang, Jamie S.

AU - Gross, Myron D.

AU - Zeuske, Melanie A.

PY - 1997/2/19

Y1 - 1997/2/19

N2 - Objective. - To identify predictors of red cell folate level in women attempting to become pregnant. Design. - Cohort study. Setting. - A health maintenance organization serving the Minneapolis-St Paul, Minn, area. Participants. - A total of 189 healthy, primarily white women aged 22 to 35 years enrolled in the Diana Project, a population-based prospective study of preconceptional and prenatal risks to reproductive outcomes. The sample represents 189 of 219 enrolled women who were sequentially selected from the total Diana Project sample to receive additional laboratory analyses. Main Outcome Measure. - Red cell folate level. Results. - Folic acid supplements, folic acid intake from fortified cereals, vitamin C supplements, and serum zinc level (inverse) were found to predict red cell folate levels. Previous research has shown that red cell folate levels higher than 906 nmol/L (400 ng/mL) may be optimal for the prevention of folate-responsive neural tube defects. For folic acid supplement users, folate intakes of 450 μg per day and higher corresponded to these protective levels of red cell folate. In nonusers of supplements, intakes of more than 500 μg of folate per day from foods and folic acid-fortified cereals may be needed to attain red cell folate levels higher than 906 nmol/L (400 ng/mL). Red cell folate levels higher than 906 nmol/L (400 ng/mL) were primarily found in women who took folic acid supplements. Only 1 in 4 women had red cell folate levels higher than 906 nmol/L (400 ng/mL), while 1 in 8 had red celt folate levels indicative of a negative folate balance. Addition of a daily, 400-μg folic acid supplement to the usual diet would result in red cell folate levels over 906 nmol/L (400 ng/mL) in a majority of women in this study. Conclusions. - Supplementation of diets of women of childbearing potential with 400 μg of folic acid per day would effectively raise red cell folate to levels associated with a low risk of folate-responsive neural tube defects. Protective levels of red cell folate may also be obtained by ample consumption of vegetables, fruits, and folic acid-fortified breakfast cereals. Efforts to increase folic acid supplement use and folate consumption among women of childbearing potential must go beyond fortification of refined cereal and grain products and reach women within all educational and income groups.

AB - Objective. - To identify predictors of red cell folate level in women attempting to become pregnant. Design. - Cohort study. Setting. - A health maintenance organization serving the Minneapolis-St Paul, Minn, area. Participants. - A total of 189 healthy, primarily white women aged 22 to 35 years enrolled in the Diana Project, a population-based prospective study of preconceptional and prenatal risks to reproductive outcomes. The sample represents 189 of 219 enrolled women who were sequentially selected from the total Diana Project sample to receive additional laboratory analyses. Main Outcome Measure. - Red cell folate level. Results. - Folic acid supplements, folic acid intake from fortified cereals, vitamin C supplements, and serum zinc level (inverse) were found to predict red cell folate levels. Previous research has shown that red cell folate levels higher than 906 nmol/L (400 ng/mL) may be optimal for the prevention of folate-responsive neural tube defects. For folic acid supplement users, folate intakes of 450 μg per day and higher corresponded to these protective levels of red cell folate. In nonusers of supplements, intakes of more than 500 μg of folate per day from foods and folic acid-fortified cereals may be needed to attain red cell folate levels higher than 906 nmol/L (400 ng/mL). Red cell folate levels higher than 906 nmol/L (400 ng/mL) were primarily found in women who took folic acid supplements. Only 1 in 4 women had red cell folate levels higher than 906 nmol/L (400 ng/mL), while 1 in 8 had red celt folate levels indicative of a negative folate balance. Addition of a daily, 400-μg folic acid supplement to the usual diet would result in red cell folate levels over 906 nmol/L (400 ng/mL) in a majority of women in this study. Conclusions. - Supplementation of diets of women of childbearing potential with 400 μg of folic acid per day would effectively raise red cell folate to levels associated with a low risk of folate-responsive neural tube defects. Protective levels of red cell folate may also be obtained by ample consumption of vegetables, fruits, and folic acid-fortified breakfast cereals. Efforts to increase folic acid supplement use and folate consumption among women of childbearing potential must go beyond fortification of refined cereal and grain products and reach women within all educational and income groups.

UR - http://www.scopus.com/inward/record.url?scp=0031057030&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031057030&partnerID=8YFLogxK

M3 - Article

VL - 277

SP - 548

EP - 552

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0002-9955

IS - 7

ER -

Brown JE, Jacobs DR, Hartman TJ, Barosso GM, Stang JS, Gross MD et al. Predictors of red cell folate level in women attempting pregnancy. Journal of the American Medical Association. 1997 Feb 19;277(7):548-552.