Prepregnancy habitual intakes of total, supplemental, and food folate and risk of gestational diabetes mellitus: A prospective cohort study
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Prepregnancy habitual intakes of total, supplemental, and food folate and risk of gestational diabetes mellitus : A prospective cohort study. / Li, Mengying; Li, Shanshan; Chavarro, Jorge E.; Gaskins, Audrey J.; Ley, Sylvia H.; Hinkle, Stefanie N.; Wang, Xiaobin; Ding, Ming; Bell, Griffith; Bjerregaard, Anne A.; Olsen, Sjurdur F.; Mills, James L.; Hu, Frank B.; Zhang, Cuilin.
In: Diabetes Care, Vol. 42, No. 6, 2019, p. 1034-1041.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Prepregnancy habitual intakes of total, supplemental, and food folate and risk of gestational diabetes mellitus
T2 - A prospective cohort study
AU - Li, Mengying
AU - Li, Shanshan
AU - Chavarro, Jorge E.
AU - Gaskins, Audrey J.
AU - Ley, Sylvia H.
AU - Hinkle, Stefanie N.
AU - Wang, Xiaobin
AU - Ding, Ming
AU - Bell, Griffith
AU - Bjerregaard, Anne A.
AU - Olsen, Sjurdur F.
AU - Mills, James L.
AU - Hu, Frank B.
AU - Zhang, Cuilin
N1 - Publisher Copyright: © 2019 by the American Diabetes Association.
PY - 2019
Y1 - 2019
N2 - OBJECTIVE To identify novel modifiable risk factors of gestational diabetes mellitus (GDM) by examining the association between prepregnancy habitual folate intake and GDM risk. RESEARCH DESIGN AND METHODS The study included 14,553 women in the Nurses’ Health Study II who reported at least one singleton pregnancy between the 1991 and 2001 questionnaires. Prepregnancy intakes of total folate, supplemental folate, and food folate were assessed using a food frequency questionnaire administered every 4 years. Incident GDM was ascertained from a self-reported physician diagnosis. Relative risks (RRs) of GDM were estimated using log-binomial models, with adjustment for demographic, lifestyle, and dietary factors. RESULTS Over the study follow-up, 824 incident GDM cases were reported among 20,199 pregnancies. Women with adequate total folate intake (‡400 mg/day) had an RR of GDM of 0.83 (95% CI 0.72, 0,95, P = 0.007) compared with women with inadequate intake (<400 mg/day). This association was entirely driven by supplemental folate intake. The RRs of GDM for 1–399, 400–599, and ‡600 mg/day of supplemental folate intake were 0.83, 0.77, and 0.70, respectively, compared with no supplemental folate intake (Ptrend = 0.002). The association between supplemental folate intake and GDM risk largely persisted after additional adjustment for intake of multivitamins and other micronutrients, as well as among women who likely planned for the pregnancy. CONCLUSIONS Higher habitual intakes of supplemental folate before pregnancy were significantly associated with lower GDM risk. If confirmed, these findings indicate that prepregnancy folic acid supplementation could offer a novel and low-cost avenue to reduce GDM risk.
AB - OBJECTIVE To identify novel modifiable risk factors of gestational diabetes mellitus (GDM) by examining the association between prepregnancy habitual folate intake and GDM risk. RESEARCH DESIGN AND METHODS The study included 14,553 women in the Nurses’ Health Study II who reported at least one singleton pregnancy between the 1991 and 2001 questionnaires. Prepregnancy intakes of total folate, supplemental folate, and food folate were assessed using a food frequency questionnaire administered every 4 years. Incident GDM was ascertained from a self-reported physician diagnosis. Relative risks (RRs) of GDM were estimated using log-binomial models, with adjustment for demographic, lifestyle, and dietary factors. RESULTS Over the study follow-up, 824 incident GDM cases were reported among 20,199 pregnancies. Women with adequate total folate intake (‡400 mg/day) had an RR of GDM of 0.83 (95% CI 0.72, 0,95, P = 0.007) compared with women with inadequate intake (<400 mg/day). This association was entirely driven by supplemental folate intake. The RRs of GDM for 1–399, 400–599, and ‡600 mg/day of supplemental folate intake were 0.83, 0.77, and 0.70, respectively, compared with no supplemental folate intake (Ptrend = 0.002). The association between supplemental folate intake and GDM risk largely persisted after additional adjustment for intake of multivitamins and other micronutrients, as well as among women who likely planned for the pregnancy. CONCLUSIONS Higher habitual intakes of supplemental folate before pregnancy were significantly associated with lower GDM risk. If confirmed, these findings indicate that prepregnancy folic acid supplementation could offer a novel and low-cost avenue to reduce GDM risk.
U2 - 10.2337/dc18-2198
DO - 10.2337/dc18-2198
M3 - Journal article
C2 - 31010874
AN - SCOPUS:85066454750
VL - 42
SP - 1034
EP - 1041
JO - Diabetes Care
JF - Diabetes Care
SN - 1935-5548
IS - 6
ER -
ID: 306528209