Association Between Maternal 2nd Trimester Plasma Folate Levels and Infant Bronchiolitis

Shanda Vereen, Tebeb Gebretsadik, Nia Johnson, Terryl J. Hartman, Sreenivas P. Veeranki, Chandrika Piyathilake, Edward F. Mitchel, Mehmet Kocak, William O. Cooper, William D. Dupont, Frances Tylavsky, Kecia N. Carroll

Research output: Contribution to journalArticle

Abstract

Objectives Viral bronchiolitis is the most common cause of infant hospitalization. Folic acid supplementation is important during the periconceptional period to prevent neural tube defects. An area of investigation is whether higher prenatal folate is a risk factor for childhood respiratory illnesses. We investigated the association between maternal 2nd trimester plasma folate levels and infant bronchiolitis. Methods We conducted a retrospective cohort analysis in a subset of mother-infant dyads (n = 676) enrolled in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood study and Tennessee Medicaid. Maternal folate status was determined using 2nd trimester (16–28 weeks) plasma samples. Bronchiolitis diagnosis in the first year of life was ascertained using International Classification of Diagnosis-9 codes from Medicaid administrative data. We used multivariable logistic regression to assess the adjusted association of prenatal folate levels and infant bronchiolitis outcome. Results Half of the women in this lower-income and predominately African-American (84%) study population had high levels of folate (median 2nd trimester level 19.2 ng/mL) and 21% of infants had at least one bronchiolitis healthcare visit. A relationship initially positive then reversing between maternal plasma folate and infant bronchiolitis was observed that did not reach statistical significance (p overall =.112, p nonlinear effect =.088). Additional adjustment for dietary methyl donor intake did not significantly alter the association. Conclusions for Practice Results did not confirm a statistically significant association between maternal 2nd trimester plasma folate levels and infant bronchiolitis. Further work is needed to investigate the role of folate, particularly higher levels, in association with early childhood respiratory illnesses.

Original languageEnglish (US)
Pages (from-to)164-172
Number of pages9
JournalMaternal and child health journal
Volume23
Issue number2
DOIs
StatePublished - Feb 15 2019

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Bronchiolitis
Folic Acid
Mothers
Medicaid
Viral Bronchiolitis
Neural Tube Defects
African Americans
Hospitalization
Cohort Studies
Logistic Models
Tissue Donors
Learning
Delivery of Health Care

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health

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Vereen, S., Gebretsadik, T., Johnson, N., Hartman, T. J., Veeranki, S. P., Piyathilake, C., ... Carroll, K. N. (2019). Association Between Maternal 2nd Trimester Plasma Folate Levels and Infant Bronchiolitis. Maternal and child health journal, 23(2), 164-172. https://doi.org/10.1007/s10995-018-2610-2

Association Between Maternal 2nd Trimester Plasma Folate Levels and Infant Bronchiolitis. / Vereen, Shanda; Gebretsadik, Tebeb; Johnson, Nia; Hartman, Terryl J.; Veeranki, Sreenivas P.; Piyathilake, Chandrika; Mitchel, Edward F.; Kocak, Mehmet; Cooper, William O.; Dupont, William D.; Tylavsky, Frances; Carroll, Kecia N.

In: Maternal and child health journal, Vol. 23, No. 2, 15.02.2019, p. 164-172.

Research output: Contribution to journalArticle

Vereen, S, Gebretsadik, T, Johnson, N, Hartman, TJ, Veeranki, SP, Piyathilake, C, Mitchel, EF, Kocak, M, Cooper, WO, Dupont, WD, Tylavsky, F & Carroll, KN 2019, 'Association Between Maternal 2nd Trimester Plasma Folate Levels and Infant Bronchiolitis', Maternal and child health journal, vol. 23, no. 2, pp. 164-172. https://doi.org/10.1007/s10995-018-2610-2
Vereen S, Gebretsadik T, Johnson N, Hartman TJ, Veeranki SP, Piyathilake C et al. Association Between Maternal 2nd Trimester Plasma Folate Levels and Infant Bronchiolitis. Maternal and child health journal. 2019 Feb 15;23(2):164-172. https://doi.org/10.1007/s10995-018-2610-2
Vereen, Shanda ; Gebretsadik, Tebeb ; Johnson, Nia ; Hartman, Terryl J. ; Veeranki, Sreenivas P. ; Piyathilake, Chandrika ; Mitchel, Edward F. ; Kocak, Mehmet ; Cooper, William O. ; Dupont, William D. ; Tylavsky, Frances ; Carroll, Kecia N. / Association Between Maternal 2nd Trimester Plasma Folate Levels and Infant Bronchiolitis. In: Maternal and child health journal. 2019 ; Vol. 23, No. 2. pp. 164-172.
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abstract = "Objectives Viral bronchiolitis is the most common cause of infant hospitalization. Folic acid supplementation is important during the periconceptional period to prevent neural tube defects. An area of investigation is whether higher prenatal folate is a risk factor for childhood respiratory illnesses. We investigated the association between maternal 2nd trimester plasma folate levels and infant bronchiolitis. Methods We conducted a retrospective cohort analysis in a subset of mother-infant dyads (n = 676) enrolled in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood study and Tennessee Medicaid. Maternal folate status was determined using 2nd trimester (16–28 weeks) plasma samples. Bronchiolitis diagnosis in the first year of life was ascertained using International Classification of Diagnosis-9 codes from Medicaid administrative data. We used multivariable logistic regression to assess the adjusted association of prenatal folate levels and infant bronchiolitis outcome. Results Half of the women in this lower-income and predominately African-American (84{\%}) study population had high levels of folate (median 2nd trimester level 19.2 ng/mL) and 21{\%} of infants had at least one bronchiolitis healthcare visit. A relationship initially positive then reversing between maternal plasma folate and infant bronchiolitis was observed that did not reach statistical significance (p overall =.112, p nonlinear effect =.088). Additional adjustment for dietary methyl donor intake did not significantly alter the association. Conclusions for Practice Results did not confirm a statistically significant association between maternal 2nd trimester plasma folate levels and infant bronchiolitis. Further work is needed to investigate the role of folate, particularly higher levels, in association with early childhood respiratory illnesses.",
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AU - Vereen, Shanda

AU - Gebretsadik, Tebeb

AU - Johnson, Nia

AU - Hartman, Terryl J.

AU - Veeranki, Sreenivas P.

AU - Piyathilake, Chandrika

AU - Mitchel, Edward F.

AU - Kocak, Mehmet

AU - Cooper, William O.

AU - Dupont, William D.

AU - Tylavsky, Frances

AU - Carroll, Kecia N.

PY - 2019/2/15

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N2 - Objectives Viral bronchiolitis is the most common cause of infant hospitalization. Folic acid supplementation is important during the periconceptional period to prevent neural tube defects. An area of investigation is whether higher prenatal folate is a risk factor for childhood respiratory illnesses. We investigated the association between maternal 2nd trimester plasma folate levels and infant bronchiolitis. Methods We conducted a retrospective cohort analysis in a subset of mother-infant dyads (n = 676) enrolled in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood study and Tennessee Medicaid. Maternal folate status was determined using 2nd trimester (16–28 weeks) plasma samples. Bronchiolitis diagnosis in the first year of life was ascertained using International Classification of Diagnosis-9 codes from Medicaid administrative data. We used multivariable logistic regression to assess the adjusted association of prenatal folate levels and infant bronchiolitis outcome. Results Half of the women in this lower-income and predominately African-American (84%) study population had high levels of folate (median 2nd trimester level 19.2 ng/mL) and 21% of infants had at least one bronchiolitis healthcare visit. A relationship initially positive then reversing between maternal plasma folate and infant bronchiolitis was observed that did not reach statistical significance (p overall =.112, p nonlinear effect =.088). Additional adjustment for dietary methyl donor intake did not significantly alter the association. Conclusions for Practice Results did not confirm a statistically significant association between maternal 2nd trimester plasma folate levels and infant bronchiolitis. Further work is needed to investigate the role of folate, particularly higher levels, in association with early childhood respiratory illnesses.

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