The Association Of Perinatal Folic Acid Supplementation With The Risk Of Gestational Diabetes Mellitus And Pregnancy Outcomes

Background and PurposeIn the context of the global obesity epidemic,the prevalence of GDM is rapidly increasing and will continue to increase.GDM has serious adverse effects on maternal and offspring health through genetic and environmental mechanisms,and its pathogenesis is still not fully understood.However,while folic acid has been developed as an important public health service for the prevention of Neural tube defects,it has been found in population-based epidemiological studies that regular folic acid supplementation increases the risk of gestational diabetes.To explore the correlation between the total time of folic acid supplementation and the incidence of GDM and its influence on pregnancy outcome,to provide scientific guidance for rational folic acid supplement.The research methodsBasic information was collected from 615 pregnant women who visited a third class A hospital in Anhui from January 2019 to January 2020.Statistics of folic acid supplementation during pregnancy,Glucose stress test（OGTT）during pregnancy,At the end of pregnancy,a blood sample of 5ml cord blood was collected from the umbilical vein during cesarean section or after vaginal delivery.Folic acid levels in cord blood were measured using a folic acid test kit.Pregnancy results were retrieved from hospital birth records and newborn birth information was recorded.They were divided into four groups based on the timing of folic acid supplementation: Pregnant women who did not take folic acid had T1;The supplement time from 1 to 60 days is T2;Supplement time 61 to 180 days is T3;The replenishment time of 180 to 360 days is T4.Excel was used to input data and SPSS 26.0 software was used for statistical analysis of the four groups of patients,To investigate the effects of folic acid supplementation time and folic acid level in umbilical cord blood on the occurrence and outcome of gestational diabetes mellitus.Results160 of the 615 pregnant women were diagnosed with GDM,with an incidence of about 26%,Only 6.3% of those surveyed took folic acid regularly,and pregnant women with lower education levels took folic acid supplements for a shorter time（x~2=22.84,p=0.007）,Pearson correlation regression analysis showed that the total time of folic acid supplementation was not correlated with the risk of GDM,birth weight,body length,and head circumference,There was no correlation between the time of folic acid supplementation and the level of folic acid in cord blood（p=0.173）,and there was no statistical difference between the time of folic acid supplementation and the occurrence of macrosomia and fetal growth restriction（p > 0.05）.The level of folic acid in cord blood had no correlation with the length and head circumference of newborn,but had negative correlation with birth weight,Multivariate linear regression analysis showed that folic acid supplementation for more than 180 days increased blood glucose at 1 hour postprandial and 2 hours postprandial,but did not increase the risk of gestational diabetes.ConclusionThere was no significant correlation between the total time of folic acid supplementation and GDM incidence and pregnancy outcome,Umbilical cord blood folic acid levels were inversely associated with normal neonatal weight.It is recommended that pregnant women with normal pregnancy can appropriately extend the time of folic acid use,and patients with gestational diabetes can take folic acid regularly until the third month after pregnancy.