Effects of maternal folate and vitamin b12 on gestational diabetes mellitus: a dose-response meta-analysis of observational studies

ABSTRACT To comprehensively estimate the association of gestational diabetes mellitus (GDM) risk with maternal red blood cell (RBC) folate, plasma/serum folate, dose and duration of folic

acid supplement (FAS) intake and vitamin B12 separately. PubMed, Web of science, CNKI, and Wanfang Databases were searched through March 26, 2021. We synthesized data using random-effects

model meta-analysis in Stata 12.0. Sensitivity, subgroup and dose-response analyses were also performed. The certainty of evidence was evaluated using the Grading of Recommendations,

Assessment, Development and Evaluations (GRADE). Twenty six datasets from thirteen eligible observational studies were included in the study. We found a significant increase of GDM risk with

the highest versus lowest category of RBC folate (OR = 1.96, 95% CI: 1.48–2.61, I2 = 0.0%, moderate-certainty evidence) and plasma/serum folate (OR = 1.23, 1.02–1.48, I2 = 57.8%,

low-certainty evidence). The dose-response analysis revealed that each 200 ng/ml increase in RBC folate was significantly associated with 8% higher GDM risk. No significant association

between dose of FAS intake and GDM risk was found with very low cetainty. Meanwhile, longer duration (≥3 months) of FAS conferred 56% significant higher GDM risk (OR = 1.56, 1.02–2.39, very

low certainty evidence). No significant association of GDM risk with highest plasma/serum B12 was observed compared to lowest B12 (OR = 0.77, 0.58–1.02, very low-certainty evidence).

Moderate-certainty evidence suggests that higher RBC folate appears to significantly increase GDM risk. Higher plasma/serum folate may increase GDM risk but with low certainty. Further

well-designed trials or prospective studies are needed. Access through your institution Buy or subscribe This is a preview of subscription content, access via your institution ACCESS OPTIONS

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META-ANALYSIS Article Open access 13 September 2021 ASSOCIATION OF MATERNAL GUT MICROBIAL METABOLITES WITH GESTATIONAL DIABETES MELLITUS: EVIDENCE FROM AN ORIGINAL CASE-CONTROL STUDY,

META-ANALYSIS, AND MENDELIAN RANDOMIZATION Article 02 September 2024 LONGITUDINAL ASSESSMENT OF MATERNAL MICRONUTRIENTS (FOLATE AND VITAMIN B12) AND HOMOCYSTEINE LEVELS IN WOMEN WHO DEVELOP

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Many thanks to Professor Ling Wang and Dr. Songyuan Deng for the valuable suggestions on the revision of the article. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Nutrient,

Zhengzhou Central Hospital Affiliated to Zhengzhou University, No.195, Tongbai Road, Zhengzhou, China Nana Li * Department of Big Data Center for Cardiovascular Disease, Henan Provincial

People’s Hospital, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, China Jicheng Jiang * Hospital Infection Management Section, Zhengzhou

Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China Leilei Guo Authors * Nana Li View author publications You can also search for this author inPubMed Google Scholar *

Jicheng Jiang View author publications You can also search for this author inPubMed Google Scholar * Leilei Guo View author publications You can also search for this author inPubMed Google

Scholar CONTRIBUTIONS NL developed the idea and study design; NL and JJ carried out the literature searching, data-extracting and critical appraisal; NL, JJ and LG performed the statistical

analyses and interpretation; NL drafted and edited the manuscript; JJ and LG gave advice on extensive revision. All authors have read and approved the submission of final manuscript.

CORRESPONDING AUTHOR Correspondence to Nana Li. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no competing interests. ADDITIONAL INFORMATION PUBLISHER’S NOTE Springer Nature

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RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Li, N., Jiang, J. & Guo, L. Effects of maternal folate and vitamin B12 on gestational diabetes

mellitus: a dose-response meta-analysis of observational studies. _Eur J Clin Nutr_ 76, 1502–1512 (2022). https://doi.org/10.1038/s41430-022-01076-8 Download citation * Received: 20 May 2021

* Revised: 05 January 2022 * Accepted: 11 January 2022 * Published: 01 February 2022 * Issue Date: November 2022 * DOI: https://doi.org/10.1038/s41430-022-01076-8 SHARE THIS ARTICLE Anyone

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