Both low and high folate levels during pregnancy linked to increased heart defects in babies

Medical Xpress / JAMA Network Open ^ | Oct. 14, 2024 | Justin Jackson / Yanji Qu et al

[ConservativeMind]

Pregnant women with either low or excessively high levels of folate in their blood may face a greater risk of their children developing congenital heart disease (CHD), according to a study.

Folate is a B vitamin. The role of folate in preventing CHD is unclear.

Researchers found a U-shaped relationship between the mothers' serum folate levels during early pregnancy and the risk of CHD in offspring. This indicates both low and high folate levels are linked to an increased risk of CHD.

The study involved 129 children diagnosed with CHD and 516 without. Maternal blood samples were taken around the 16th week of pregnancy to measure folate, vitamin B12, and homocysteine levels. The mothers' serum data was grouped by folate count into low( 25%), middle (50%), and high (25%).

Mothers in the low folate level group had more than 3 times the odds of having a child with CHD compared to mothers in the middle range. Those in the highest folate group also showed an increased risk, with 1.81 times the odds of CHD in their children.

Children born to mothers with a vitamin B12 deficiency and low folate had a 7 times higher risk of CHD. In the high folate group, B12 deficiency was associated with a 6 times higher CHD risk.

Elevated homocysteine levels and low folate showed nearly 9 times the odds of developing CHD and 7 times higher risk in the high folate group.

The higher rates of elevated homocysteine levels accounted for approximately 32.9% of the association between low folate levels and increased CHD risk.

It can be caused by mutations in genes encoding enzymes in the methionine-homocysteine cycle, which leads to insufficient conversion of homocysteine back to methionine. Since the normal cycle uses the vitamin B group, elevated folate and B12 would be expected.

[ConservativeMind]

Low or high folate, high homocysteine, and low B-12 independently increased congenital heart disease, but together, it can make the risk up to nine times worse for your child.

The normal risk is 2.3%. Nine times that is 20.7%.

[ConservativeMind]

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[Dr. Sivana]

This is a good time to mention that some people have a MYHFR genetic mutation. That means that the folic acid found in most processed breads and rice in the U.S. not only cannot be processed by someone with that mutation, but that the same folic acid interferes with the proper absorption of real folate.

This issue was only discovered a few years ago, long after folic acid (as an inexpensive source of folate) was pretty much mandated for U.S. wheat and rice products. Not a huge issue for most, catastrophic for those with that mutation.

[Dr. Sivana]

I should have described that as an MTHFR mutation.