Background/Aims: Folic acid may affect bone formation in utero and influence offspring bone mass and fracture risk. We thus aimed to determine the association between maternal folate consumption and supplementation with offspring bone health.
Method: Pregnant women were recruited from the Geelong Hospital (n=475). Women self-reported dietary intake (µg/day), using the Cancer Council Food Frequency Questionnaire and folate supplementation (yes/no) at recruitment (before 16 weeks gestation) and 28-32 weeks gestation. Mother-child pairs returned for the 11-year follow-up (n=210), of which 175 (83.3%) had complete data for the current analyses. Trained personnel measured offspring’s bone mineral density (BMD), content (BMC) and area using dual-energy X-ray absorptiometry (Lunar) and obtained parental reported childhood fractures. Regression modelling was used to examine associations between dietary folate and supplementation and bone health and was adjusted for child height, weight, sex and Tanner stage.
Results: Women consumed more folate in early pregnancy vs late [302µg (226-357) vs 278µg (213-324)], and 46 (26.3%), 117 (66.9%) and 61 (34.9%) took a folate supplement before and in early and late pregnancy, respectively. There were 42 fractures (2 clavicle, 17 forearm, 6 elbow, 6 wrist, 4 finger, 1 toe, 1 nose and 5 unknown) from 36 children. There was a positive trend between dietary folate in early pregnancy and total body less head (TBLH) BMD (β=0.00006, p=0.068). Supplementation at recruitment was associated with spine BMC (β=1.49, p=0.023), spine area (β=0.87, p=0.015) and TBLH-area (β=29.2, p=0.021). No associations were found between dietary folate or supplementation with fracture risk at any other time point, nor associations with folate intake or supplementation at 28-32 weeks with any outcome.
Conclusions: Maternal folate supplementation during early gestation, but not late, was associated with aspects of offspring bone health. Folate supplementation in early pregnancy may influence bone development in utero, and therefore bone health in childhood.