COMMENTARY

Autism and Folic Acid in Pregnancy

William T. Basco, Jr., MD, MS

Disclosures

May 07, 2013

In This Article

Association Between Maternal Use of Folic Acid Supplements and Risk of Autism Spectrum Disorders in Children

Surén P, Roth C, Bresnahan M, et al
JAMA. 2013;309:570-577

Folic Acid in Pregnancy

Although the use of folic acid among childbearing women and specifically during pregnancy has been shown to reduce neural tube defects, fewer studies have evaluated the association between folic acid supplementation and other neurodevelopmental problems. Small, intriguing studies have suggested that maternal intake of folic acid before pregnancy is associated with lower risk for autism spectrum disorders (ASDs) in children, but this is the first large cohort study to evaluate this potential association.

Study Methods

This Norwegian cohort enrolled 109,000 children born from 2002 to 2008. The mothers were recruited during pregnancy at approximately 18 weeks' gestation. The rate of diagnosis of ASDs in their children was obtained through questionnaires, referrals, and national registries. Cases of ASD were categorized as autism; Asperger syndrome; or pervasive developmental disorder, not otherwise specified (PDD-NOS).

Maternal intake of dietary supplements was determined by survey at the 18-week gestation visit, and a dietary questionnaire at 22 weeks determined dietary folic acid intake. The time window of interest for folic acid intake was from 4 weeks before conception until 8 weeks after conception. The investigators accounted for parental education, parental age, whether the pregnancy was planned, smoking during pregnancy, maternal body mass index, weight gain during the pregnancy, parity, and year of birth. The investigators also collected data on maternal use of fish oil supplements and analyzed the association between fish oil supplementation and ASDs in offspring.

  • Association Between Maternal Use of Folic Acid Supplements and Risk of Autism Spectrum Disorders in Children
  • Study Findings
  • Viewpoint

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