The use of supplemental folic acid from four weeks before to eight weeks after the start of pregnancy was associated with a lower risk of autistic disorder in children, a new fresh study reaffirms.
By Samuel Swerdlow, 13-Feb-2013
Supplements of folic acid were connected with a 39% lower risk of autistic disorder in children, compared with children whose mothers did not take any folic acid, according to a comprehensive research recently published.
“Our main finding was that maternal use of folic acid supplements around the time of conception was associated
with a lower risk of autistic disorder,” wrote the researchers, led by Pal Surén, MD, of the Norwegian Institute of Public Health, Oslo.
It is very important to note that no causality relationship has been established between folic acid and the increased incidence of Autism.
“This finding does not establish a causal relation between folic acid use and autistic disorder but provides a rationale for replicating the analyses in other study samples and further investigating genetic factors and other biological mechanisms that may explain the inverse association.”
Folic acid in pregnancy:
Folic acid before and during early pregnancy decreases the chances of the fetus developing the neural tube defect – commonly known as Spina bifida. Women of child-bearing age need sufficient body reserves of Folate before conception to avoid folate-sensitive neural tube defects (NTDs), which accounts for 20% to 60%of all NTDs.
For this reason, recommending folic acid supplementation before conception is wise but not very practical, mainly due to the fact that many pregnancies are unplanned, and the average time until the first postnatal visit is 9 weeks. In other words, neural tube defects may have already occurred before this time.
For this reason, since 1998, the USA government has promoted mandatory fortification of staple foods with folic acid; To date over 50 countries around the world have followed the US example in adopting fortification of food, most noticeably in cereals.
Robert Berry, MD, and colleagues at the Centers for Disease Control and Prevention in Atlanta affirmed that this study is reassuring as it clearly demonstrates that there is no correlation between the increase in Autism and the increase of fortification of foods with folic acid. However, Dr. Berry remains conservative concerning the results of the study and declares that more research has to be done.
“This should ensure that folic acid intake can continue to serve as a tool for the prevention of neural tube birth
defects. The potential for a nutritional supplement to reduce the risk of autistic disorder is provocative and should be confirmed in other populations.”
The depth of the Study:
Pal Surén, MD led the analysis of data from 85,176 children born between 2002 and 2008 from the Norwegian Mother and Child Cohort Study. His team of scientists compared the use of folic acid from 4 weeks before to 8 weeks after the start of pregnancy and the incidence of autism spectrum disorders (ASDs) (autistic disorder, Asperger's syndrome, Pervasive Developmental Disorder-Not Otherwise Specified [PDD-NOS]).
Over the course of the study, 270 children (0.32%) were diagnosed with ASDs, and the researchers found that there was an inverse association between folic acid use and subsequent risk of autistic disorder.
Specifically, autistic disorder was present in 0.10% of children whose mothers took folic acid, compared with 0.21% in children whose mothers did not take folic acid - a 39% reduction in the odds of autistic disorder in children of folic acid users.
“No association was found with Asperger syndrome or PDD-NOS, but power was limited. Similar analyses for
prenatal fish oil supplements showed no such association with autistic disorder, even though fish oil use was
associated with the same maternal characteristics as folic acid use,” added the researchers.
“Association Between Maternal Use of Folic Acid Supplements and Risk of Autism Spectrum Disorders in Children”
Authors: P. Surén, C. Roth, M. Bresnahan et al.
2013, Volume 309, Number 6, Pages 570-577, doi:10.1001/jama.2012.155925
“Periconceptional Folic Acid and Risk of Autism Spectrum Disorders”
Authors: R.J. Berry, K.S. Crider, M. Yeargin-Allsopp
2013, Volume 309, Number 6, Pages 611-613