Importance of Folic Acid Supplements During Pregnancy

Preventing Neural Tube Defects

Folic acid supplements are crucial during pregnancy to prevent neural tube defects and support normal brain development. Research is ongoing to ascertain whether excessive levels of folic acid might negatively impact cognitive development in children.

Role of Folic Acid

Folic acid, also known as vitamin B9, plays a vital role in cell division, amino acid fusion, and DNA synthesis. Additionally, it is essential for the formation of red blood cells, which are necessary for fetal tissue growth and blood volume. The supplementation of folic acid contributes to the development of the spine, brain, and skull, helping to prevent serious neural tube defects and birth defects related to the spinal cord. While folic acid is available in various foods, it can also be consumed through multivitamin supplements.

Recent Findings on Folic Acid Dosages

Recent studies indicate that there is a tolerable level of folic acid supplementation, and excessive dosages may lead to adverse effects on cognitive development in children.

Effects of High Dosages of Folic Acid Supplements

Study Overview

A study published in the American Journal of Clinical Nutrition by Valera-Gran and colleagues examined the impact of high folic acid dosages during pregnancy on neuropsychological development in children aged four to five years. This multicenter prospective mother-child cohort study was conducted across four regions of Spain, involving 1,682 mother-child pairs recruited between 2003 and 2008.

Methodology

Pregnant women were enrolled when they were between 10-13 weeks of gestation at public hospitals or health centers. Participants completed food-frequency questionnaires to estimate folate intake at two intervals: between 10-13 weeks and again at 28-32 weeks. When the children reached ages four to five, their neuropsychological development was assessed using the McCarthy Scales of Children’s Abilities (MSCA) and their BMI was measured.

Key Findings

Results indicated that 54.8% of the women did not meet the recommended folic acid dosage during the periconception period, while 29.8% consumed 1,000 µg/d or more. The data showed that for every additional 100 µg/d of dietary folate, there was an increase of 1.27 and 1.25 points in global memory and visual scores, respectively. However, children whose mothers consumed less than 400 µg/d exhibited significantly lower verbal memory scores compared to those whose mothers took over 1,000 µg/d. Importantly, high dosages of folic acid (1,000 µg/d or greater) were negatively correlated with cognitive functions related to verbal abilities, indicating that excessive intake may hinder cognitive development.

Implications for Children’s Cognitive Development

Study Conclusions

This study highlights the dual nature of folic acid supplements; while they are beneficial, excessive amounts can adversely affect children’s cognitive development. It is one of the few studies to analyze cognitive outcomes in children aged four to five years relative to maternal folic acid intake during the periconception period.

Limitations and Strengths

Despite its significance, the study faced limitations, including participant dropout in the longitudinal design and variations in socioeconomic status among participants. However, its strengths lie in the comprehensive analysis of potential confounding variables and the detailed data collected regarding folic acid dosages and timing of supplementation.

Recommendations

The findings underscore the necessity of monitoring folic acid intake during pregnancy. It is advisable for expectant mothers to avoid very high dosages of folic acid during the periconception period unless instructed by a healthcare professional.

References

BabyCenter Medical Advisory Board. (2016). Folic acid: Why you need it before and during pregnancy. Retrieved from https://www.babycenter.com/0_folic-acid-why-you-need-it-before-and-during-pregnancy_476.bc

Centrum. (2016). What is folic acid? Retrieved from https://www.centrum.ca/learn/articles/what-folic-acid.

Valera-Gran, D., Navarrete-Munoz, E., Garcia de la Hera, M., et al. (2017). Effect of maternal high dosages of folic acid supplements on neurocognitive development at 4-5 years of age: the prospective birth cohort Infancia y Medio Ambiente (INMA) study. American Journal of Clinical Nutrition (AJCN), DOI: 10.3945/AJCN.117.152769.