CDC Scientific Articles on Blood Folate Concentrations

CDC’s National Center on Birth Defects and Developmental Disabilities produced the following scientific findings which were important in the WHO guideline development process. Please see spotlighted articles below.

Population red blood cell folate concentrations for the prevention of neural tube defects
British Medical Journal published a study about the association between the amount of folate in women’s blood and the risk of having a pregnancy affected by a neural tube defect, such as spina bifida or anencephaly. In this study, CDC researchers and other scientists found that blood folate concentrations can predict the risk of neural tube defects in a population. These findings will be useful for public health officials interested in understanding the risk of folate-sensitive neural tube defects in their communities and planning prevention programs. You can learn more about the key findings from this paper here or read the article’s abstract here.

Assessing the association between natural food folate intake and blood folate concentrations
The journal Nutrients has published a new study that assessed the relationship between the amount of natural food folate consumed by women and their blood folate concentrations. In this study, CDC researchers conducted a systematic review and meta-analysis and found that consuming natural food folate affects blood folate concentrations and adequate food folate consumption by women could help them achieve red blood cell folate concentrations that reduce their risk of having a pregnancy affected by a neural tube defect. However, it is difficult for a woman to eat enough natural food folate to prevent neural tube defects. These findings will be useful for public health professionals and policymakers interested in preventing neural tube defects through a variety of interventions including folic acid fortification, supplementation, as well as through diet. You can learn more about the key findings from this paper here or read the article’s abstract here.

Using the new WHO guideline, CDC has described the United States population of reproductive-aged women who meet the red blood folate concentration threshold for optimal prevention of neural tube defects and sub-populations at increased risk for neural tube defects because of insufficient concentrations, highlighted below.

Blood folate concentrations and risk of neural tube defect-affected pregnancies: Where does the United States stand?
Birth Defects Research Part A has published a new study that looked at the amount of folate in the blood (“blood folate concentrations”) among women in the United States in relation to their risk of having a baby affected by a neural tube defect. In this study, CDC researchers found that more than 3 out of 4 (77.2%) women in the United States had blood folate concentrations at levels that would optimally prevent pregnancies affected by neural tube defects. These findings are useful for identifying population subgroups at greater risk for pregnancies affected by neural tube defects and targeting the ways to better prevent neural tube defects in those groups. You can learn more about the key findings from this paper here or read the article’s abstract here.

References for Additional CDC Scientific Articles on Blood Folate Concentrations

Berry RJ, Li Z, Erickson JD, Li S, Moore CA, Wang H et al. Prevention of neural-tube defects with folic acid in China. China-U.S. Collaborative Project for Neural Tube Defect Prevention. N Engl J Med. 1999;341(20):1485–90.
http://www.ncbi.nlm.nih.gov/pubmed/10559448

Crider KS, Zhu JH, Hao L, Yang QH, Yang TP, Gindler J et al. MTHFR 677C->T genotype is associated with folate and homocysteine concentrations in a large, population-based, double- blind trial of folic acid supplementation. Am J Clin Nutr. 2011;93(6):1365–72. doi:10.3945/ ajcn.110.004671.
http://www.ncbi.nlm.nih.gov/pubmed/21508090

Fazili Z, Pfeiffer CM, Zhang M. Comparison of serum folate species analyzed by LC-MS/MS with total folate measured by microbiologic assay and Bio-Rad radioassay. Clin Chem. 2007;53(4):781–4.
http://www.ncbi.nlm.nih.gov/pubmed/17272488

Fazili Z, Pfeiffer CM, Zhang M, Jain RB, Koontz D. Influence of 5,10 methylenetetrahydrofolate reductase polymorphism on whole-blood folate concentrations measured by LC-MS/MS, microbiologic assay, and bio-rad radioassay. Clin Chem. 2008;54(1):197–201.
http://www.ncbi.nlm.nih.gov/pubmed/18160726

Marchetta CM, Hamner HC. Blood folate concentrations among women of childbearing age by race/ethnicity and acculturation, NHANES 2001–2010. Matern Child Nutr. 2014; 17 June epub ahead of print. doi:10.1111/mcn.12134.
http://www.ncbi.nlm.nih.gov/pubmed/24934272

Pfeiffer CM, Hughes JP, Lacher DA, Bailey RL, Berry RJ, Zhang M et al. Estimation of trends in serum and RBC folate in the U.S. population from pre- to postfortification using assay-adjusted data from the NHANES 1988–2010. J Nutr. 2012;142(5):886–93. doi:10.3945/jn.111.
http://www.ncbi.nlm.nih.gov/pubmed/22437563

Pfeiffer CM, Schleicher RL, Johnson CL, Coates PM. Assessing vitamin status in large population surveys by measuring biomarkers and dietary intake – two case studies: folate and vitamin D. Food Nutr Res. 2012;56. doi:10.3402/fnr.v56i0.5944.
http://www.ncbi.nlm.nih.gov/pubmed/22489219

Pfeiffer CM, Zhang M, Lacher DA, Molloy AM, Tamura T, Yetley EA et al. Comparison of serum and red blood cell folate microbiologic assays for national population surveys. J Nutr. 2011;141(7):1402–9. doi:10.3945/jn.111.141515.
http://www.ncbi.nlm.nih.gov/pubmed/21613453

Tinker SC, Hamner HC, Berry RJ, Bailey LB, Pfeiffer CM. Does obesity modify the association of supplemental folic acid with folate status among nonpregnant women of childbearing age in the United States? Birth Defects Res A Clin Mol Teratol. 2012;94(10):749–55. doi:10.1002/bdra.23024.
http://www.ncbi.nlm.nih.gov/pubmed/22641603

Tsang BL, Devine OJ, Cordero AM, Marchetta CM, Mulinare J, Mersereau P et al. Assessing the association between the methylenetetrahydrofolate reductase (MTHFR) 677CàT polymorphism and blood folate concentrations: a systematic review and meta-analysis of trials and observational studies. Am J Clin Nutr. 2015;Mar 18. pii: ajcn099994. [Epub ahead of print].
http://www.ncbi.nlm.nih.gov/pubmed/25788000