OBJECTIVE - To determine whether folate metabolism in pregnant diabetic wom
en is significantly different from that in pregnant nondiabetic women, thus
predisposing them to having offspring with major congenital anomalies.
RESEARCH DESIGN AND METHODS - A total of 31 pregnant diabetic women and 54
pregnant nondiabetic control subjects were studied at their first prenatal
visits. Dietary folate intake, serum folate, red blood cell folate, urinary
folate, and homocysteine were measured and compared after controlling for
folate supplementation. Among diabetic women, the relationships among param
eters of folate metabolism and glycemic control were also assessed.
RESULTS - There were no significant differences between the pregnant diabet
ic and nondiabetic women for any measures of folate metabolism after accoun
ting for folate supplementation. In addition, among diabetic women, there w
ere no associations among parameters of folate metabolism and glycemic cont
rol.
CONCLUSIONS - Abnormal folate metabolism does not appear to occur in pregna
nt diabetic women. It is unlikely that deranged folate metabolism explains
the higher incidence of major anomalies in infants of diabetic mothers. The
se results do not diminish the importance of periconception folate suppleme
ntation or preclude other possible scenarios that could restrict folate use
by the embryo, leading to congenital anomalies.