{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T14:45:13Z","timestamp":1780497913842,"version":"3.54.1"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The relationships between folic acid supplementation, folate intake, and GDM remain controversial. We conducted a preliminary investigation using a multimethod approach integrating a retrospective cohort study, Mendelian randomization, and dose\u2013response analysis to explore this association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We examined the relationship between folic acid supplement use (including a combination preparation) and the GDM risk in a retrospective cohort of 10,479 pregnant women receiving care at Jiangsu Provincial People\u2019s Hospital using multivariable logistic regression analysis. MR analysis provides genetic support for a potential causal link between genetically predicted folic acid supplement use and GDM. A cross-sectional analysis of 3,680 pregnant women in the National Health and Nutrition Examination Survey (NHANES) evaluated total folate intake and dietary folate equivalents (DFEs) via 24-h dietary recall; multivariable logistic regression and restricted cubic spline models were used to characterize associations and generate dose\u2013response curves. The models were adjusted for age, BMI, race or ethnic origin, education, and smoking history. Subgroup analyses were performed to assess potential effect modifications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In this retrospective cohort study, compared with non-users, folic acid supplement users had a 46.2% greater likelihood of having GDM (OR\u202f=\u202f1.46, 95% CI: 1.339\u20131.595;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). MR analysis supported a potential causal association between genetically predicted folic acid products and GDM risk (OR\u202f=\u202f1.40, 95% CI 1.17\u20131.67,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). In the NHANES cohort, higher total folate (OR\u202f=\u202f1.42, 95% CI: 1.05\u20131.92,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.02) and DFE intake (OR\u202f=\u202f1.61, 95% CI: 1.23\u20132.10,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) were linked to an increased GDM risk, with non-linear dose\u2013response inflection points at approximately 445\u202f\u03bcg\/day and 582\u202f\u03bcg\/day, respectively. These associations were generally maintained after multivariable adjustment, and subgroup analyses revealed consistent trends toward an increased risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This multimethod study indicates that both supplemental folic acid and dietary folate intake may be associated with an increased GDM risk. These observations support the need for additional research to better understand the potential impact of current recommendations on prenatal folate levels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1665917","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T13:40:56Z","timestamp":1771249256000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Associations of folic acid supplements and dietary folate intake with gestational diabetes mellitus: complementary evidence from a multimethod investigation"],"prefix":"10.3389","volume":"13","author":[{"given":"Yanyan","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University","place":["Nanjing, Jiangsu, China"]},{"name":"Division of Geriatric, Liyang People\u2019s Hospital, Liyang Branch Hospital of Jiangsu Province Hospital","place":["Changzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifang","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University","place":["Nanjing, Jiangsu, China"]},{"name":"Department of Clinical Medical Research, The Friendship Hospital of Ili Kazakh Autonomous Prefecture","place":["Yining, Xinjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jizheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanfei","family":"Mo","sequence":"additional","affiliation":[{"name":"Nanjing Pukou District Chinese Medicine Hospital","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wensong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of the Core Facility, The First Affiliated Hospital of Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjie","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Lu","sequence":"additional","affiliation":[{"name":"Women and Children Department of the First Affiliated Hospital of Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Lu","sequence":"additional","affiliation":[{"name":"Women and Children Department of the First Affiliated Hospital of Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1940","DOI":"10.3390\/nu11081940","article-title":"GDM and nutrition-answered and unanswered questions-there's more work to do!","volume":"11","author":"Simmons","year":"2019","journal-title":"Nutrients"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e51718","DOI":"10.2196\/51718","article-title":"Process evaluations of interventions for the prevention of type 2 diabetes in women with gestational diabetes mellitus: 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Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1665917\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T11:28:26Z","timestamp":1771932506000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1665917\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,16]]},"references-count":50,"alternative-id":["10.3389\/fnut.2026.1665917"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2026.1665917","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,16]]},"article-number":"1665917"}}