Summary
This narrative review synthesises evidence on B-vitamins and one-carbon metabolism during pregnancy, examining their role beyond the established neural tube defect prevention to include emerging evidence for hypertensive disorder prevention and intergenerational effects on child neurodevelopment. The authors highlight that whilst physiological pregnancy induces declining B-vitamin status, no pregnancy-specific reference ranges or dietary recommendations currently exist to distinguish adequate maternal status from deficiency risk. The review addresses gaps in understanding how genetic polymorphisms and endocrine signals interact with B-vitamin intake to regulate one-carbon metabolism during this critical window.
Regional applicability
The findings are broadly applicable to United Kingdom practice and policy. UK public health guidance on periconceptional folic acid supplementation aligns with the established evidence cited; however, the review's identification of gaps in pregnancy-specific B-vitamin criteria and dietary recommendations suggests areas where United Kingdom maternal nutrition policy could be strengthened, particularly regarding broader B-vitamin assessment beyond folate.
Key measures
B-vitamin biomarkers (folate, B12, B6, riboflavin status); neural tube defect outcomes; hypertensive disorders in pregnancy; offspring neurodevelopment and cognitive performance; one-carbon metabolism pathway markers
Outcomes reported
The review evaluates evidence for B-vitamins in preventing hypertensive disorders in pregnancy and intergenerational effects on offspring neurodevelopment and cognitive performance. It examines one-carbon metabolism pathways during pregnancy and identifies gaps in pregnancy-specific B-vitamin reference ranges and dietary recommendations.
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