(Reuters Health) – Women who take folic acid and multivitamins before and during pregnancy may be less likely to have children with autism than mothers who don’t use these supplements, an Israeli study suggests.
Vitamin deficiencies in mothers have long been linked to neural tube defects. While pregnant women are advised to take folic acid and multivitamins in part to prevent neural tube defects, research to date has offered a mixed picture of whether this might also minimize the risk of autism.
For the current study, researchers examined prescription data for the mothers of 45,300 Israeli children born between 2003 and 2007. By 2015, 572 of these children, or 1.3%, had received a diagnosis of autism spectrum disorder (ASD).
Women who took folic acid, multivitamins, or both supplements before pregnancy were 61% less likely to have an autistic child, the study found. When women took supplements during pregnancy, they were 73% less likely to have a kid with autism, researchers report online January 3 in JAMA Psychiatry.
“The results reinforce existing evidence that maternal use of prenatal vitamins and folic acid are associated with a reduced risk of autism in offspring,” said lead study author Stephen Levine of the University of Haifa.
“In addition, our results suggest that factors before pregnancy may be a target for further scrutiny to reduce the likelihood of autism,” Levine said by email.
Autism is relatively common, and globally affects 1 in 160 children, according to the World Health Organization. The exact cause is unclear, but scientists suspect that a variety of environmental and genetic factors may play a role.
The current study included 11,917 children whose mothers took folic acid or prenatal vitamins alone or in combination before they became pregnant, as well as 21,884 kids born to mothers who did so during pregnancy.
Mothers who only used folic acid had a 44% lower risk of having a child with autism when they used it before pregnancy and 68% lower risk when they took it during pregnancy.
Women who used only prenatal vitamins had 64% lower odds of having an autistic child when they took them before pregnancy and a 65% lower risk when they took the vitamins during pregnancy.
The study wasn’t a controlled experiment designed to prove whether or how taking folic acid or prenatal vitamins might directly prevent autism. Prescription data may also not be an accurate reflection of which women took the supplements.
“It is still unclear if folic acid or other micronutrients are what confers this reduced risk of ASD,” said Joseph Braun, a researcher at Brown University School of Public Health in Providence, Rhode Island, who wasn’t involved in the study.
“In addition, other behavioral or lifestyle factors (e.g. more physical activity, lower rates of obesity) may be the real factors that reduce the risk of ASD and these are more likely to be present in women with multivitamin and folic acid supplement use,” Braun said by email.
Even if the potential for autism prevention isn’t certain, women should start taking folic acid before pregnancy and continue through at least the first trimester to prevent neural tube defects, said Rebecca Schmidt, a researcher at the MIND Institute at the University of California, Davis School of Medicine in Sacramento.
“The critical dose and timing for folic acid supplementation to prevent autism remains unclear,” Schmidt, who wasn’t involved in the study, said by email.
While starting supplements before pregnancy is ideal, results from this study and others suggests that women can still benefit if they don’t start until after they become pregnant, said Dr. Pal Suren of the Norwegian Institute of Public Health in Oslo.
“These studies provide yet another reason for taking folic acid, in addition to the preventive effect against neural tube defects that has already been demonstrated,” Suren, who wasn’t involved in the study, said by email.
SOURCE: http://bit.ly/2rDqNJN
JAMA Psychiatry 2018.
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