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The Impact of Maternal Pre-Pregnancy Body Weight and Gestational Diabetes on Markers of Folate Metabolism in the Placenta

Martino, Jole; Segura, Maria; Garc�a-Vald�s, Luz; Padilla, M; Rueda, Ricardo; McArdle, Harry; Budge, Helen; Symonds, Michael; Campoy, Cristina


Jole Martino

Maria Segura

Luz Garc�a-Vald�s

M Padilla

Ricardo Rueda

Harry McArdle

Professor of Neonatal Medicine

Michael Symonds

Cristina Campoy


Dietary methyl donors, including folate, may modify the placenta and size at birth but the influence of maternal body weight has not been widely investigated. We therefore examined whether maternal or fetal folate status, together with indices of placental folate transport, were modulated by either maternal pre-pregnancy body mass index (BMI i.e., overweight: 25 ≤ BMI < 30 or obesity: BMI ≥ 30 kg/m2) and/or gestational diabetes mellitus (GD). We utilised a sub-sample of 135 pregnant women participating in the Spanish PREOBE survey for our analysis (i.e., 59 healthy normal weight, 29 overweight, 22 obese and 25 GD). They were blood sampled at 34 weeks gestation, and, at delivery, when a placental sample was taken together with maternal and cord blood. Placental gene expression of folate transporters and DNA methyltransferases (DNMT) were all measured. Folate plasma concentrations were determined with an electro-chemiluminescence immunoassay. Food diaries indicated that folate intake was unaffected by BMI or GD and, although all women maintained normal folate concentrations (i.e., 5–16 ng/mL), higher BMIs were associated with reduced maternal folate concentrations at delivery. Umbilical cord folate was not different, reflecting an increased concentration gradient between the mother and her fetus. Placental mRNA abundance for the folate receptor alpha (FOLR1) was reduced with obesity, whilst DNMT1 was increased with raised BMI, responses that were unaffected by GD. Multi-regression analysis to determine the best predictors for placental FOLR1 indicated that pre-gestational BMI had the greatest influence. In conclusion, the placenta’s capacity to maintain fetal folate supply was not compromised by either obesity or GD.


Martino, J., Segura, M., García-Valdés, L., Padilla, M., Rueda, R., McArdle, H., …Campoy, C. (2018). The Impact of Maternal Pre-Pregnancy Body Weight and Gestational Diabetes on Markers of Folate Metabolism in the Placenta. Nutrients, 10(11), Article 1750.

Journal Article Type Article
Acceptance Date Nov 10, 2018
Online Publication Date Nov 13, 2018
Publication Date Nov 13, 2018
Deposit Date Nov 22, 2018
Publicly Available Date Nov 22, 2018
Journal Nutrients
Electronic ISSN 2072-6643
Publisher MDPI
Peer Reviewed Peer Reviewed
Volume 10
Issue 11
Article Number 1750
Keywords Food Science
Public URL
Publisher URL


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