The Reus-Tarragona Birth Cohort study followed 831 mother-infant pairs from early pregnancy until birth. It was coordinated by the Unit of Preventive Medicine & Biostatistics, Faculty of Medicine & Health Sciences, IISPV, Universitat Rovira i Virgili in collaboration with the Areas of Obstetrics & Gynaecology of the University Hospitals Sant Joan, Reus and Joan23 Tarragona. Biological, clinical and lifestyle data were collected from pregnant mothers, throughout pregnancy and at birth. Currently the offspring is being followed up at 7.5-8 and 16-18 years.
The essential vitamins, folate and cobalamin (vitamin B12), play inter-dependent roles in foetal development, with lifelong consequences for health and development. Women of reproductive age, that may become pregnant, should take folic acid supplements (400 µg/ day) to prevent developmental anomalies in the foetus. The evidence is so strong that more than 80 countries have implemented mandatory fortification of flour/ cereal-based products with folic acid, to reduce the incidence of neural tube defects resulting from folate deficiency, in the foetus. European countries have not implemented this policy. Cobalamin deficiency is widely believed to only affect older adults, vegans and vegetarians.
Results from the Reus-Tarragona Birth Cohort Study show that only 36% of mothers took folic acid before they became pregnant. 47% had insufficient folate status and 7% had insufficient cobalamin status to protect the foetus from neural tube defects. None of the mothers were vegan. Low early pregnancy folate status was associated with more than double the risk of early pregnancy miscarriage.
Early pregnancy folate and cobalamin status monitoring should be included in prenatal clinical guidelines and campaigns are needed to raise folate and cobalamin deficiency awareness in women, especially with the growing trend towards vegetarian and vegan diets.
The findings are published in The American Journal of Clinical Nutrition (2024)
(Image by John Looy from Unsplash)
Unit of Preventive Medicine & Biostatistics. Faculty of Medicine & Health Sciences, IISPV, Universitat Rovira i Virgili, Spain. Expert in the role of folate and cobalamin in maternal health and very early life health and development. Drs. Michelle Murphy and Dr. Pere Cavallé-Busquets, are the Principal Investigators of the Reus Tarragona Birth Cohort Study.