Autism and Folic Acid in Pregnancy
Autism and Folic Acid in Pregnancy
The final sample included more than 85,000 children, with an age range of 3.3-10.2 years at the conclusion of the study. Of this cohort, 270 (0.32%) children were diagnosed with ASD.
When folic acid use in the first interval (before pregnancy to 8 weeks gestation) was examined, 33% of mothers were taking folic acid, increasing to 71% in weeks 9-12. By weeks 13-16, only 46% of the mothers were taking folic acid. The factors associated with the use of folic acid in the first interval were higher levels of education, planned pregnancy, being a nonsmoker, and being a first-time mother. Folic acid use increased from 43.2% to 83.7% over the study period.
In regression analyses, there was an inverse association between folic acid supplementation and the risk for ASD. ASD was diagnosed in 0.1% of the infants whose mothers took folic acid compared with 0.21% of infants whose mothers did not take folic acid. The adjusted odds ratio (OR) was 0.61 (95% confidence interval [CI], 0.41-0.90). Fish oil supplementation was associated with the same demographic factors (maternal education, planned pregnancy, etc.) as folic acid use, and the use of fish oil also increased over the study time window. However, there was no difference in the rate of diagnosis of ASD in children of mothers who took fish oil supplement compared with the children of mothers who did not. Mid-pregnancy use of folate was not associated with risk for being diagnosed with ASD. The adjusted OR for Asperger syndrome was 0.65; however, the 95% CI was 0.36-1.16, failing to reach statistical significance. The adjusted OR for prevention of PDD-NOS was 1.04.
The investigators concluded that maternal use of folic acid from 4 weeks before conception through 8 weeks after conception was associated with a lower odds of the offspring being diagnosed with ASD.
Study Findings
The final sample included more than 85,000 children, with an age range of 3.3-10.2 years at the conclusion of the study. Of this cohort, 270 (0.32%) children were diagnosed with ASD.
When folic acid use in the first interval (before pregnancy to 8 weeks gestation) was examined, 33% of mothers were taking folic acid, increasing to 71% in weeks 9-12. By weeks 13-16, only 46% of the mothers were taking folic acid. The factors associated with the use of folic acid in the first interval were higher levels of education, planned pregnancy, being a nonsmoker, and being a first-time mother. Folic acid use increased from 43.2% to 83.7% over the study period.
In regression analyses, there was an inverse association between folic acid supplementation and the risk for ASD. ASD was diagnosed in 0.1% of the infants whose mothers took folic acid compared with 0.21% of infants whose mothers did not take folic acid. The adjusted odds ratio (OR) was 0.61 (95% confidence interval [CI], 0.41-0.90). Fish oil supplementation was associated with the same demographic factors (maternal education, planned pregnancy, etc.) as folic acid use, and the use of fish oil also increased over the study time window. However, there was no difference in the rate of diagnosis of ASD in children of mothers who took fish oil supplement compared with the children of mothers who did not. Mid-pregnancy use of folate was not associated with risk for being diagnosed with ASD. The adjusted OR for Asperger syndrome was 0.65; however, the 95% CI was 0.36-1.16, failing to reach statistical significance. The adjusted OR for prevention of PDD-NOS was 1.04.
The investigators concluded that maternal use of folic acid from 4 weeks before conception through 8 weeks after conception was associated with a lower odds of the offspring being diagnosed with ASD.
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