Prenatal Folic Acid Supplements Tied to Lower Risk of Kawasaki Disease in Babies

— Japanese observational research study recommends a flexible danger aspect

by
Crystal PhendContributing Editor, MedPage Today
January 1, 2024

Folic acid supplements throughout pregnancy was associated with a lower threat of early-onset Kawasaki illness in offspring, a Japanese observational research study revealed.

In a tendency score-matched design, kids of ladies with above-average serum folic acid levels throughout the 2nd and 3rd trimesters had a considerably lower occurrence of Kawasaki illness by 12 months of age compared to the kids of those with listed below the 10 ng/mL average (0.27% vs 0.41%; OR 0.68, 95% CI 0.50-0.92), reported Shuichi Ito, MD, PhD, of Yokohama City University in Japan, and associates in JAMA Network Open

The CDC and other federal firms suggest that all ladies of childbearing age take a folic acid supplement to avoid neural tube problems in unintended pregnancies, however day-to-day supplements is likewise advised through pregnancy to keep shops of this B vitamin that has actually been connected to lower danger of anemia, hereditary heart illness, oral cleft, and potentially preterm birth.

In this research study, folic acid supplements was connected with a lower occurrence of Kawasaki illness, with a nonsignificant pattern for very first trimester usage (0.34% vs 0.42%; OR 0.83, 95% CI 0.66-1.04) and a considerable link throughout the 2nd and 3rd trimesters (0.30% vs 0.43%; OR 0.73, 95% CI 0.57-0.94).

“On the basis of these findings, we hypothesize that taking extra folic acid supplements with a suitable diet plan throughout pregnancy might lower the threat of [Kawasaki disease] in offspring,” the scientists concluded.

Kawasaki illness, with its particular fever, rash, red eyes and tongue, and inflamed soles and palms, is presumed to be an immune-mediated illness set off by infectionalthough the precise cause stays unsure.

In regards to system, Ito’s group kept in mind the function of folic acid in DNA methylation, which might equate to an immunologic effect.

“For example, folic acid prevents swelling by reducing cytokines and chemokines from inflammatory cells or by keeping lymphocyte function,” they composed. Proof recommends that “maternal serum folic acid levels might cause epigenetic modifications in immune cells, which, in turn, cause distinctions in the threat of [Kawasaki disease] amongst offspring.”

Evidence would need a potential randomized scientific trial to develop a causal relationship in between maternal folic acid supplements throughout pregnancy and kids’s subsequent threat of Kawasaki illness, Ito and coworkers kept in mind.

The research study utilized information from the Japan Environment and Children’s Study, an across the country birth friend, with 87,702 kids with 12-month follow-up considering that 2011.

Maternal serum folic acid levels of 10 ng/mL or higher (the 50th percentile in the friend) were categorized as exposed. Typical serum folate levels vary from 2.7 to 17.0 ng/mL. Maternal folic acid supplements as soon as a week or more was categorized as exposed for that procedure. Not remarkably, the 31.7% of ladies who took folic acid supplements balanced greater folate levels than those who didn’t take the supplements.

In the research study population, 336 kids established Kawasaki illness. Maternal dietary folic acid consumption in both the Kawasaki illness and control groups balanced 260 μg each day, although the World Health Organization advises dietary folic acid consumption of a minimum of 480 μg each day.

The scientists kept in mind the requirement for additional observational research studies with a longer follow-up duration beyond the 12 months in this research study.

“In addition, we were not able to examine the result of folic acid alone since the supplements taken by getting involved moms might have been complicated supplements, such as multivitamins, instead of supplements consisting of folic acid alone,” they included. “There is likewise unmeasured confounding that was not changed in the tendency rating analysis.”