ReviewNutrients2021
Epidemiology and (Patho)Physiology of Folic Acid Supplement Use in Obese Women before and during Pregnancy.
Review in Nutrients, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- FIGO good practice recommendations on anemia in pregnancy, to reduce the incidence and impact of postpartum hemorrhage (PPH).International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Guideline
- Periconceptional biomarkers for maternal obesity: a systematic review.Reviews in endocrine & metabolic disorders · 2023Pooled it
- Dietary Interventions Targeting Maternal Obesity: Intergenerational Effects, Mechanisms, and Translational Insights.Current nutrition reports · 2026Review
- Dietary folate intake and metabolic dysfunction-associated steatotic liver disease: a prospective cohort study.Nutrition & metabolism · 2026Article
- The maternal and infant gut microbiome: implications for pregnancy outcomes, immune development, and health in the first 1000 days.Journal of translational medicine · 2026Review
- The role of chrysanthemum phytochemicals in neural tube development: a narrative review of underlying mechanisms.Frontiers in cell and developmental biology · 2026Review
- Spina Bifida Incidence Trends: A Comparative Study of Puerto Rico and the United States.Epidemiologia (Basel, Switzerland) · 2025Article
- Lifestyle Modifications Prior to Pregnancy and Their Impact on Maternal and Perinatal Outcomes: A Review.Journal of clinical medicine · 2025Review
- Comparative analysis of plasma folate, homocysteine and erythrocyte folate levels in pregnant women after folic acid administration during different pregnancies.Journal of medical biochemistry · 2025Article
- Unveiling the mechanistic nexus: how micronutrient enrichment shapes brain function, and cognitive health.Frontiers in molecular biosciences · 2025Review
- Differential Impacts of Prenatal Supplement Intake on Childhood Obesity Markers, Stratified by Gender and Other Prenatal Factors.Journal of obesity · 2025Article
- Association between serum and red blood cell folate concentrations and urinary phthalate metabolite concentrations in US adults: evidence from a large population-based study.Frontiers in nutrition · 2025Article
- Maternal pre-pregnancy overweight or obesity and risk of birth defects in offspring: Population-based cohort study.Acta obstetricia et gynecologica Scandinavica · 2024Article
- The influence of maternal diet on offspring's gut microbiota in early life.Archives of gynecology and obstetrics · 2024Review
- Association between dietary folate intake and severe headache among adults in the USA: a cross-sectional survey.The British journal of nutrition · 2024Article
- Dietary niacin intake in relation to depression among adults: a population-based study.BMC psychiatry · 2023Article
- Article
- Mechanisms of Maternal Diet-Induced Obesity Affecting the Offspring Brain and Development of Affective Disorders.Metabolites · 2023Review
- Nutritional deficiency in South African adults scheduled for bariatric surgery.Frontiers in endocrinology · 2023Article
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Preconception folic acid supplement use is a well-known method of primary prevention of neural tube defects (NTDs). Obese women are at a higher risk for having a child with a NTD. As different international recommendations on folic acid supplement use for obese women before and during pregnancy exist, this narrative review provides an overview of epidemiology of folate deficiency in obese (pre)pregnant women, elaborates on potential mechanisms underlying folate deficiency, and discusses considerations for the usage of higher doses of folic acid supplements. Women with obesity more often suffer from an absolute folate deficiency, as they are less compliant to periconceptional folic acid supplement use recommendations. In addition, their dietary folate intake is limited due to an unbalanced diet (relative malnutrition). The association of obesity and NTDs also seems to be independent of folate intake, with studies suggesting an increased need of folate (relative deficiency) due to derangements involved in other pathways. The relative folate deficiency, as a result of an increased metabolic need for folate in obese women, can be due to: (1) low-grade chronic inflammation (2) insulin resistance, (3) inositol, and (4) dysbiotic gut microbiome, which plays a role in folate production and uptake. In all these pathways, the folate-dependent one-carbon metabolism is involved. In conclusion, scientific evidence of the involvement of several folate-related pathways implies to increase the recommended folic acid supplementation in obese women. However, the physiological uptake of synthetic folic acid is limited and side-effects of unmetabolized folic acid in mothers and offspring, in particular variations in epigenetic (re)programming with long-term health effects, cannot be excluded. Therefore, we emphasize on the urgent need for further research and preconception personalized counseling on folate status, lifestyle, and medical conditions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.