The fourth generation of folates and preconception care

Česká verzia

Authors: Tomáš Fait
Authors place of work: Gynekologicko-porodnická klinika 1. LF UK a VFN, Praha
Published in the journal: Prakt Gyn 2014; 18(4): 246-250
Category: Gynecology and Obstetrics

Summary

The tendency of reproduction delay leads to a higher rate of planned conception. This allows preconception intervention. The importance of folate administration is well documented. Folates reduce the incidence of neural tube defects, congenital heart defects, congenital anomalies of urinary tract, foetuses with lower birth weight, placental pathology and spontaneous abortion. Seventeen German professional societies recommend folate supplementation for at least one month before pregnancy and in the first trimester. Methylfolate [(6S) -5methyltetrahydrofolic acid] is the biologically active folate which is not dependent on the activity of MTHFR. Recently, glucosamine salt of methylfolate (folate of 4th generation) has been introduced and is characterized by greater stability, solubility and bioavalability in comparison to known calcium salts (folate of 3rd generation).

Key words:
folic acid – Quatrefolic^® – pregnancy – congenital developmental defects

Zdroje

1. Czeizel AE, Dudás I, Métkeni J. Pregnancy outcomes in a randomised controlled trial of periconceptional multivitamin supplementation. Final report. Arch Gynecol Obstet 1994, 225(3): 131–139.

2. Botto LD, Yang Q. 5,10-methyltetrahydrofolate reduktase gene variants and congenital anomalies: a HuGE review. Am J Epidemiol 2000, 151(9): 862–877.

3. Czeizel AE. The primary prevention of birth defects: multivitamins of folic acid? Int J Med Sci 2004, 1(1): 50–61.

4. De Wals P, Tairou F, Van Allen M et al. Reduction in neural tube defects after folic acid fortification in Canada. New Engl J Med 2007, 357(2): 135–142.

5. Lamers Y. Red blood cell folate concentrations increase more after supplementation with (6S)-5-methyltetrahydrofolate than with folic acid in women of child bearing age. Am J Clin Nutr 2006, 84(1): 156–161.

6. Li DK, Daling JR, Mueller BA et al. Periconceptional multivitamin use in relation to the risk of congenital urinary tract anomalies. Epidemiology 1995; 6(3): 212–218.

7. Milunsky A, Jick H, Jick S et al. Multivitamin/folic acid supplementation in early pregnancy reduces the prevalence of neural tube defects. JAMA 1989; 262(20): 2847–2852.

8. Nelen WL, Blom HJ, Steegers EA et al. Homocysteine nad folate levels as risk factors for recurrent early pregnancy loss. Obstet Gynecol 2000; 95(4): 519–24.

9. Nurk E, Tell GS, Refsum H et al. Associations between maternal methylenetetrahydrofolate reductase polymorphisms and adverse outcomes of pregnancy: the Hordaland Homocysteine Study. Am J Med 2004; 117(1): 26–31.

10. Pentiva K, McNulty H, Reichert R et al. The short term bioavailabilities of (6S)-5-methyltetrahydrofolate and folic acid are equivalent in men. J Nutr 2004, 134(3): 580–585.

11. Pietrzik K, Prinz R, Bung P et al. Folate status and pregnancy outcome. Ann N Y Acad Sci 1992; 669: 371–374.

12. Shaw GM, Carmichael SL, Nelson V et al. Occurence of low birthweight and preterm delivery among California infants before and after compulsory food fortification with folic acid. Public Health Rep 2004; 19(2): 170–173.

13. Werler AS, Shapiro S, Mitchel A. Periconceptional folic acid exposure and risk of occurent neural tube defects. JAMA 1993, 269(10): 1257–1261.