title: Red blood cell folate levels in pregnant women with a history of mood disorders: a case series.
abstract: BACKGROUND
  Maternal folate supplementation reduces offspring risk for neural tube defects (NTDs) and other congenital abnormalities. Maternal red blood cell (RBC) folate concentrations of >906 nmol/L have been associated with the lowest risk of having a neural tube defect affected pregnancy. Mood disorders (e.g., depression, bipolar disorder) are common among women and can be associated with folate deficiency. Thus, pregnant women with histories of mood disorders may be prone to RBC folate levels insufficient to provide optimal protection against neural tube defects. Although previous studies have assessed RBC folate concentrations in pregnant women from the general population, none have looked specifically at a group of pregnant women who have a history of a mood disorder.
  
  
  METHODS
  We collected data about RBC folate concentrations and folic acid supplement intake during early pregnancy (<161 days gestation) from n = 24 women with histories of mood disorders. We also collected information about offspring congenital abnormalities and birth weight.
  
  
  RESULTS
  Among women with histories of mood disorders, the mean RBC folate concentration was 674 nmol/L (range, 362-1105 nmol/L). Only 12.5% (n = 3) of the women had RBC folate concentrations >906 nmol/L, despite all participants reporting current daily use of folic acid supplements. Data regarding offspring were available for 22 women: birth weights ranged from 2296 g to 4819 g, and congenital abnormalities were identified in two (hypoplastic left heart, annular pancreas).
  
  
  CONCLUSIONS
  Data from this exploratory case series suggest a need for future larger scale controlled studies investigating RBC folate concentrations in early pregnancy and offspring outcomes among women with and without histories of mood disorders.
authors.affiliation: Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Elyse
authors.initials: E
authors.lastname: Yaremco
authors.forename: Angela
authors.initials: A
authors.lastname: Inglis
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Innis
authors.forename: Catriona
authors.initials: C
authors.lastname: Hippman
authors.forename: Prescilla
authors.initials: P
authors.lastname: Carrion
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Lamers
authors.forename: William G
authors.initials: WG
authors.lastname: Honer
authors.forename: Jehannine
authors.initials: J
authors.lastname: Austin
mesh_terms: D001955:British Columbia; D019587:Dietary Supplements / Q000706:statistics & numerical data*; D004912:Erythrocytes / Q000378:metabolism*; D005260:Female; D005492:Folic Acid / Q000097:blood*; D006801:Humans; D019964:Mood Disorders / Q000097:blood*; D011247:Pregnancy; D011256:Pregnancy Outcome
chemical_list: D005492:Folic Acid