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Compared with women who had no exposure to supplements during pregnancy, women who took folic acid and/or multivitamins had a significantly reduced risk of having offspring with autism spectrum disorder (ASD), with a relative risk of 0.27, according to the study published yesterday in JAMA Psychiatry. Mothers who took folic acid and vitamin supplements before pregnancy had a relative risk of 0.41 compared with mothers who did not.
For the study, researchers followed 45,300 Israeli children born between 2003 and 2007, until 2015; 1.3% were diagnosed with ASD, according to the study by Stephen Z. Levine, Ph.D., of the University of Haifa, Israel, and colleagues.
Women are routinely advised to take folic acid or multivitamins during pregnancy to avoid neural tube defects in their children, but previous studies of an association between the supplements and the risk of ASD in their offspring have been inconsistent.
For this observational study, children with ASD were compared with children without it to identify whether maternal use of folic acid and multivitamin supplements might play a role. The researchers examined health care organization data, including pharmacy dispensation of folic acid and multivitamin prescriptions, to pregnant women.
They examined whether supplements were dispensed to the pregnant women before pregnancy (540 days to 271 days before childbirth) and during pregnancy (9 months before childbirth, up to the date of birth). A diagnosis of ASD of their children was made after evaluation by a panel of experts, including a behavioral pediatrician.
Among offspring whose parents had a psychiatric disorder, folic acid supplementation before pregnancy did not provide the same protective effect against ASD, the researchers found. They theorized this finding might reflect noncompliance with the vitamin regimens, or possibly higher rates of vitamin deficiency or poor nutrition among persons with psychiatric conditions.
The researchers found that most supplement dispensations occurred around the first trimester. Only 26% of children were born to mothers who took folic acid and/or multivitamin supplements before pregnancy; about 48 percent were born to mothers who took folic acid and/or multivitamins during pregnancy.
For related information, see the Psychiatric News article “Folinic Acid May ImproveVerbal Skills in Children With ASD.”
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