Fetal and Maternal Medicine Review

Review Article


YANFANG GUOa1a2a3a4, GRAEME N. SMITHa5, SHI WU WENa1a2a3a6 and MARK C WALKERa1a2 c1

a1 OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada.

a2 Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada.

a3 School of Public Health, Central South University, Changsha, Hunan, PRC.

a4 Huaihua Medical College, Huaihua, Hunan, PRC.

a5 Queen's Perinatal Research Unit, Department of Obstetrics and Gynecology, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada.

a6 Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Preeclampsia (PE) is a multisystem disorder of human pregnancy, affecting about 6% of all pregnancies worldwide, and is one of the leading causes of maternal and infant morbidity and mortality. Despite decades of research into the pathogenesis of this complex disease, the underlying mechanisms remain unclear. As a result, the options for prevention and management of PE are limited. In recent years, there has been a growing body of evidence suggesting that folate deficiency is associated with PE, and folic acid supplementation may reduce the risk of developing PE in certain populations. Folate contributes to cell division and growth, and folate metabolism is involved in a large number of physiological and pathophysiological processes in human development. Sufficient supply of folate is therefore particularly important during pregnancy. Nevertheless, the exact mechanisms of folic acid deficiency increasing the risk of developing PE are still unclear. This article reviews what is understood about the aetiology of PE and the relationship between folate metabolism and PE so as to enhance further discussions on the subject.


c1 Mark C Walker, OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Faculty of Medicine, 501 Smyth, Ottawa, Ontario K1H 8L6 Canada. E-mail: mwalker@ohri.ca


Dr Mark Walker is supported by a Tier 1 chair in Perinatal Epidemiology from the University of Ottawa.