Folic Acid Supplements in Pregnancy and Severe Language Delay in Children

Abstract

Context Prenatal folic acid supplements reduce the risk of neural tube defects and may have beneficial effects on other aspects of neurodevelopment. Objective To examine associations between mothers' use of prenatal folic acid supplements and risk of severe language delay in their children at age 3 years. Design, Setting, and Patients The prospective observational Norwegian Mother and Child Cohort Study recruited pregnant women between 1999 and December 2008. Data on children born before 2008 whose mothers returned the 3-year follow-up questionnaire by June 16, 2010, were used. Maternal use of folic acid supplements within the interval from 4 weeks before to 8 weeks after conception was the exposure. Relative risks were approximated by estimating odds ratios (ORs) with 95% CIs in a logistic regression analysis. Main Outcome Measure Children's language competency at age 3 years measured by maternal report on a 6-point ordinal language grammar scale. Children with minimal expressive language (only 1-word or unintelligible utterances) were rated as having severe language delay. Results Among 38 954 children, 204 (0.5%) had severe language delay. Children whose mothers took no dietary supplements in the specified exposure interval were the reference group (n=9052 [24.0%], with severe language delay in 81 children [0.9%]). Adjusted ORs for 3 patterns of exposure to maternal dietary supplements were (1) other supplements, but no folic acid (n=2480 [6.6%], with severe language delay in 22 children [0.9%]; OR, 1.04; 95% CI, 0.62-1.74); (2) folic acid only (n=7127 [18.9%], with severe language delay in 28 children [0.4%]; OR, 0.55; 95% CI, 0.35-0.86); and (3) folic acid in combination with other supplements (n=19005 [50.5%], with severe language delay in 73 children [0.4%]; OR, 0.55; 95% CI, 0.39-0.78). Conclusion Among this Norwegian cohort of mothers and children, maternal use of folic acid supplements in early pregnancy was associated with a reduced risk of severe language delay in children at age 3 years.

Interpregnancy Interval and Risk of Autistic Disorder

“…16,27 recent studies indicate that maternal folic acid supplementation in early pregnancy may prevent neurodevelopmental disorders in children. [28][29][30][31] a study from california found decreased risk of autistic disorder in children whose mothers had used prenatal vitamin supplements containing folic acid. 28 Studies based on a norwegian child cohort showed that maternal use of folic acid in early pregnancy was associated with decreased risk of both severe language delay and autistic disorder in the offspring.…”

“…28 Studies based on a norwegian child cohort showed that maternal use of folic acid in early pregnancy was associated with decreased risk of both severe language delay and autistic disorder in the offspring. 29,30 information about maternal use of folic acid supplements before and during pregnancy is available in the norwegian birth registry, but only for children born in 1999 or later. even then, folate use is substantially underreported.…”

Pregnant Canadian Women Achieve Recommended Intakes of One-Carbon Nutrients through Prenatal Supplementation but the Supplement Composition, Including Choline, Requires Reconsideration

“…Similarly, higher intakes or blood concentrations of vitamin B-12 (5,6), choline (7,8), betaine (7), and Met (9)(10)(11) during the periconceptional period have been inversely associated with the risk of NTDs, albeit less consistently, compared with folic acid. Additionally, high periconceptional folate exposure has been associated with improved neurodevelopment (12)(13)(14)(15) and a reduction in the risk of various pediatric cancers (16)(17)(18) in offspring. In contrast, high periconceptional folic acid exposure has been shown in some studies, but not all, to increase the risk of asthma (19), atopic dermatitis (20), obesity, and metabolic syndrome (21) and in one study to increase the risk of a detrimental effect on psychomotor development (22).…”

Brief Report: Are Autistic-Behaviors in Children Related to Prenatal Vitamin Use and Maternal Whole Blood Folate Concentrations?

“…Four reports from two studies suggest that periconceptional vitamin use, dietary folic acid intake, or folic acid supplementation are associated with a decreased risk of ASD diagnosis, severe language delay, and emotional problems. (Roth, Magnus et al 2011; Schmidt, Hansen et al 2011; Schmidt, Tancredi et al 2012; Steenweg-de Graaff, Roza et al 2012; Suren, Roth et al 2013) In one study, the association between prenatal vitamin intake and ASD diagnosis was modified by maternal polymorphisms in folate transport and bioavailability genes. (Schmidt, Hansen et al 2011) While these findings suggest a role for folate status in the development of ASD, the association between biomarkers of prenatal folate status and child ASD or autistic-behaviors has not been directly assessed.…”