Maternal Folic Acid Supplementation may mitigate Kawasaki Disease risk in infants, unravels study
In a groundbreaking cohort study
conducted by the Japan Environment and Children’s Study, researchers have
discovered a potential link between maternal folic acid levels and the onset of
Kawasaki disease in infants. The study found that the quantity and timing of folic acid supplementation plays a
pivotal role in mitigating the risk of Kawasaki disease in infants.
The
study results were published in the journal JAMA Network Open.
Kawasaki disease is a form of acute
systemic vasculitis primarily observed in infants and young children. Despite
extensive research, definitive risk factors for this condition remain elusive.
However, there has been previous speculation about a potential link between
maternal folic acid supplementation and the occurrence of Kawasaki disease.
Hence, researchers conducted a study to investigate
the associations of exposure to maternal serum folic acid levels and maternal
folic acid supplementation with the onset of Kawasaki disease during infancy
among offspring.
The study, utilizing data from a
nationwide birth cohort since 2011, analyzed information from 87,702 children
followed up to 12 months of age. Of this population, 336 children were
diagnosed with Kawasaki disease. The key focus of the investigation was on
maternal serum folic acid levels during the second and third trimesters and the
frequency of folic acid supplementation during the entire pregnancy.
The primary outcome was to measure the
onset of Kawasaki disease in offspring up to age 12
months.
Findings:
-
Mothers who took folic acid
supplements, accounting for 35.7% of the study population with a mean age of 32
years, exhibited higher serum folic acid levels compared to non-supplementing
counterparts.
Strikingly, the study found that
higher maternal serum folic acid levels (≥10 ng/mL) were associated with a
significantly lower risk of Kawasaki disease in offspring compared to lower
levels (0.27% vs 0.41%; Odds Ratio [OR] 0.68).
The findings also pointed to the
timing of maternal folic acid supplementation.- While supplementation during the
first trimester showed a trend toward a lower prevalence of Kawasaki disease,
the results were not statistically significant (0.34% vs 0.42%; OR 0.83; 95% CI
0.66-1.04). -
However, supplementation during the
second and third trimesters demonstrated a significant reduction in the risk of
Kawasaki disease (0.30% vs 0.43%; OR 0.73; 95% CI 0.57-0.94). - These results suggest that not only
the quantity but also the timing of folic acid supplementation plays a crucial
role in mitigating the risk of Kawasaki disease in infants.
The study provides
valuable insights into preventive measures for this potentially serious
condition.
The study contributes to the growing
body of evidence on the benefits of folic acid supplementation during
pregnancy. With Kawasaki disease affecting a notable number of infants, these
findings could have far-reaching implications for maternal healthcare
guidelines, emphasizing the need for adequate folic acid intake during specific
trimesters to safeguard infant health.
Further reading: Fukuda S, Tanaka S, Kawakami C, Kobayashi T, Ito S, Japan Environment and Children’s Study Group. Maternal Serum Folic Acid Levels and Onset of Kawasaki Disease in Offspring During Infancy. JAMA Netw Open. 2023;6(12):e2349942. doi:10.1001/jamanetworkopen.2023.49942
