Maternal folic acid supplementation during early pregnancy associated with lower risk of autism

Feb 12th – In a study published today, incidence of autism was found to be lower in children of mothers who took folic acid before and during early pregnancy.

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1. Incidence of autism was lower in children of mothers who took folic acid supplementation before and during early pregnancy.

Though widely speculated upon, the risk factors for development of autism are largely unknown; nonetheless, early gestation has been implicated as a period of critical susceptibility for increased risk of developing autism during life.  In the present study, the authors demonstrate a significant inverse correlation between maternal folic acid supplementation during early gestation (4 weeks prior and 8 weeks following gestation) and later diagnosis of autism.  Of note, this relationship was not noted with other autism spectrum disorders. There was also no significant association between folic acid supplementation at a later date relative to gestation (i.e. 22 weeks gestational age) and later autism diagnosis.

As the authors did not specifically record the doses of folic acid being taken, specific recommendations regarding the necessary dosage cannot be made from the results presented.  Moreover, folic acid intake during the twelve week period of interest was not stratified in greater detail, preventing the authors from delineating the most critical period for supplementation.  That said, their findings suggest that the early gestational period is at least one period of critical risk for later development of autism that may be mitigated by maternal folic acid supplementation.

Click to read the study in JAMA

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1. Incidence of autism was lower in children of mothers who took folic acid supplementation before and during early pregnancy.

This [prospective, population-based] study:  The authors compiled data on 85,176 children born between 1999 and 2009 who were enrolled in the Norwegian Mother and Child Cohort Study.  Only children of single gestations, born in the normal ranges of gestational age and weight, were included.  Prenatal folic acid supplement intake and other nutritional information were assessed via questionnaire, focusing on the period from four months prior to conception (dated by last menstrual period) through 8 weeks gestation.  Children with developmental abnormalities suspicious for autism spectrum disorders (ASDs) were confirmed via standardized diagnostic tests.  When controlling for potential confounding factors, children born to mothers who took supplemental folic acid during the four weeks prior to and eight weeks following gestation were significantly less likely to be diagnosed with autistic disorder; however, no significant relationships were found between folic acid supplementation and other ASDs.  Moreover, no similar relationships were found between other nutritional variables.

In sum: Though widely speculated upon, the risk factors for development of autism are largely unknown; nonetheless, early gestation has been implicated as a period of critical susceptibility for increased risk of developing autism during life.  In the present study, the authors demonstrate a significant inverse correlation between maternal folic acid supplementation during early gestation (4 weeks prior and 8 weeks following gestation) and later diagnosis of autism.  Of note, this relationship was not noted with other autism spectrum disorders. There was also no significant association between folic acid supplementation at a later date relative to gestation (i.e. 22 weeks gestational age) and later autism diagnosis.

As the authors did not specifically record the doses of folic acid being taken, specific recommendations regarding the necessary dosage cannot be made from the results presented.  Moreover, folic acid intake during the twelve week period of interest was not stratified in greater detail, preventing the authors from delineating the most critical period for supplementation.  That said, their findings suggest that the early gestational period is at least one period of critical risk for later development of autism that may be mitigated by maternal folic acid supplementation.

Click to read the study in JAMA

By John Prendergass Rif Rahman

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