In a recent Japanese nationwide birth cohort study involving 87,702 children, researchers discovered a significant association between higher maternal serum folic acid levels during the second and third trimesters of pregnancy and a reduced risk of Kawasaki disease (KD) onset in offspring during infancy. The study also highlighted a lower prevalence of KD in infants whose mothers supplemented with folic acid more than once a week during pregnancy. As concerns about KD, an acute systemic vasculitis primarily affecting infants, continue to rise, the findings suggest that maternal folic acid supplementation may play a protective role against this inflammatory condition in early childhood.
Key Findings:
- Maternal serum folic acid levels of ≥10 ng/mL during the second and third trimesters were associated with a lower risk of KD in infants.
- Infants born to mothers who were supplemented with folic acid more than once a week during the second and third trimesters had a reduced risk of KD.
- The study emphasizes the potential benefits of increasing maternal serum folic acid levels through supplementation to decrease the incidence of KD in offspring during infancy.
Background: KD, first described in 1967, is an acute systemic vasculitis affecting infants and young children, with potentially serious complications, including acquired pediatric heart disease. Despite its significant impact, no reproducible risk factors for KD have been identified. The study aimed to explore the association between maternal folic acid levels and supplementation during pregnancy and the onset of KD in offspring.
Methodology:
- The cohort study analyzed data from the Japan Environment and Children’s Study, a nationwide birth cohort involving 87,702 children.
- Maternal serum folic acid levels during the second and third trimesters and the frequency of maternal folic acid supplementation were examined.
- Propensity score–adjusted logistic regression was employed to assess the associations between folic acid exposure and the onset of KD in infants up to age 12 months.
Implications:
- The study suggests that maternal folic acid supplementation during pregnancy may contribute to a reduced risk of KD in infants, emphasizing the importance of maintaining adequate folic acid levels.
- Further research and prospective randomized clinical trials are needed to establish a causal relationship between maternal folic acid supplementation and KD risk reduction in offspring.
Conclusion: The findings underscore the potential protective role of maternal folic acid supplementation in mitigating the risk of early-onset Kawasaki disease in infants, providing valuable insights for maternal healthcare practices.