Journal Article

New Perspective on Impact of Folic Acid Supplementation during Pregnancy on Neurodevelopment/Autism in the Offspring Children – A Systematic Review

Zwaigenbaum, Lonnie, Walker, Mark, Xie, Ri-hua, Sheng, Chao, Asztalos, Elizabeth, Sun, Wen, Moddemann, Diane, Gao, Yunfei, Wen, Shi Wu

2016

Overview

It has been conclusively established that folic acid supplementation prior to and during early pregnancy (up to 12 weeks of gestation) can prevent neural tube defects (NTDs). We hypothesized that folate effects may extend from neuro-structural defects to alterations in neuro-behavioural and emotional skills including autism spectrum disorders (ASDs) and other developmental disorders. The objective of this review was to comprehensively evaluate evidence on the impact of folic acid on neurodevelopment other than NTDs. We conducted an online search of relevant literature compiled by the National Library of Medicine from Medline and EMBASE (searched on Dec 31, 2014: http://www.ncbi.nlm.nih.gov/entrez/query/fcgi and http://www.elsevier.com/online-tools/embase). We first created 3 files (search restricted to English literature) using the following key words: 1) folate or folic acid (171322 papers identified by this search); 2) maternal or pregnancy or pregnant or gestation or gestational or prenatal or antenatal or periconception or periconceptional (1349219 papers identified by this search); and 3) autism or autism spectrum disorders or developmental delay or development or neurodevelopment or mental or cognitive or language or personal-social or gross motor or fine motor or behaviour or intellectual or intelligence or Bayley Scale (8268145 papers identified by this search). We then merged the 3 files and reviewed the papers that addressed these three issues simultaneously. A total of 22 original papers that examined the association between folic acid supplementation in human pregnancy and neurodevelopment/autism were identified after the screening, with 15 studies showing a beneficial effect of folic acid supplementation on neurodevelopment/autism, 6 studies showed no statistically significant difference, while one study showed a harmful effect in > 5 mg folic acid supplementation/day during pregnancy. Folic acid supplementation in pregnancy may have beneficial effects on the neurodevelopment of children beyond its proven effect on NTDs.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acids / Amino acids / Autism / Autism Spectrum Disorder - prevention & control / Autistic Disorder - prevention & control / Biology and Life Sciences / Children / Children & youth / Childrens health / Cognitive ability / Cognitive development / Cohort analysis / Defects / Dietary Supplements / Disorders / Emotional behavior / Epidemiology / Female / Folic acid / Folic Acid - therapeutic use / Gestation / Gynecology / Health care / Hospitals / Human behavior / Humans / Intelligence / Internet / Medicine and Health Sciences / Neural tube defects / Neurodevelopmental disorders / Obstetrics / Offspring / Online searching / Pediatrics / People and Places / Physical Sciences / Pregnancy / Pregnant women / Preventive medicine / Public health / Research and Analysis Methods / Searching / Social Sciences / Statistical analysis / Studies / Supplementation / Supplements / Systematic review / Vitamin B