Study Finds Folic Acid May Protect Mothers and Children Against Liver Damage From Prenatal Chemical Exposure

A new study by researchers from the Icahn School of Medicine at Mount Sinai reveals that prenatal exposure to environmental chemicals and endocrine disruptors may pose significant risks to liver health for both mothers and their newborns. Additionally, the researchers found that treating folic acid and other B vitamin deficiencies in pregnancy may help counter some of the adverse effects of prenatal exposures on the livers of children.

The study, published today in the Journal of Hepatology and titled “Metabolism-Disrupting Chemical Mixtures, Folic Acid Supplementation, and Liver Injury and Steatosis in Mother-Child Pairs,” examined how prenatal exposure to metabolism-disrupting chemical mixtures impacts liver health in mother-child pairs in a Mexican population. It found evidence of increased risk for liver injury and steatosis (fat accumulation in the liver) in mothers and especially in their children, linked to air pollutant, phthalate, and pesticide exposures during pregnancy. However, maternal intake of folic acid above 600 mg daily appeared to provide protection from these chemicals, potentially reducing liver health risks in mothers and newborns. Higher concentrations of cobalt (a key component of vitamin B12) during pregnancy further appeared to have a protective role. 

“Our findings underscore the importance of maternal nutrition, particularly the role of folic acid supplementation and likely other B vitamins, in countering some of the harmful effects of environmental chemical exposures on liver health of mothers and children,” said the lead senior author, Dania Valvi, MD, PhD, MPH, Associate Professor of Environmental Medicine and Climate Science and Director of the MS in Epidemiology program at Icahn Mount Sinai. “This study adds to the growing evidence that environmental chemical exposures in combination with dietary and other environmental and genetic risk factors have contributed to the epidemic of steatotic liver disease we see globally.”

“Our study paves the way for dietary lifestyle interventions evaluating this hypothesis in a non-observational setting,” said first author Sandra India Aldana, PhD, MPH, MPhil, a postdoctoral fellow in Environmental Medicine and Climate Science at Icahn Mount Sinai. “Although the potential mitigating effects of B vitamins on the association between endocrine-disrupting chemicals and liver health show a promising avenue of research for improving liver outcomes, we must not forget that reduction of potential deleterious environmental etiological factors or restriction of widespread use of contaminants remains key to ultimately reducing the risk of liver injury onset.”

According to the Office on Women’s Health at the U.S. Department of Health and Human Services, all women need 400 micrograms of folic acid every day. Women who can get pregnant should get 400 to 800 micrograms of folic acid from a supplement or from foods that have added folic acid, such as breakfast cereals. This is in addition to the folic acid you get naturally from healthy foods, like leafy greens, legumes, avocados, and broccoli.

Harmful environmental exposures during pregnancy and early infancy can pose significant risks to a baby’s health, including potential for low birth weight, preterm birth, developmental delays, respiratory issues, and increased susceptibility to metabolic and other chronic diseases later in life, according to the World Health Organization. Reducing environmental risks could prevent one in four child deaths. Adverse environmental conditions and pollution are major contributors to childhood deaths, illnesses, and disability, particularly in developing countries.

By analyzing mother-child pairs from the Mexican PROGRESS study population, the researchers were able to study the intergenerational effects of environmental exposures on liver function in a historically understudied ethnic group, and one which is experiencing increasing rates of cardiometabolic disease. The population of Mexican descent in the US has grown from 20.9 million in 2001 to 37.2 million as of this decade, according to the Pew Research Center.

This study was supported in part by the National Institutes of Health and the National Institute of Environmental Health Sciences. The research team included experts from the Mount Sinai Institute for Climate Change, Environmental Health, and Exposomics and leading health institutes in Mexico including the National Institute of Public Health, the National Institute of Perinatology, and Iberoamericana University; and the U.S. Centers for Disease Control and Prevention, New York University School of Global Public Health, Harvard T.H. Chan School of Public Health and Brown University.

The Institute for Climate Change, Environmental Health, and Exposomics at Icahn Mount Sinai investigates the impacts of environmental exposures on health and aims to translate that knowledge into innovative strategies for prevention and treatment. Exposomics studies the health impact of all exposures an individual encounters over their lifetime. Starting at conception, an individual’s exposome encompasses environmental, nutritional, social, physical, and occupational factors, including malnutrition, air pollution, social stressors, and chemical exposures.  

For more information visit: https://mountsinaiexposomics.org