Recommendations to increase folic acid intakes during the early stages of pregnancy may reduce mental and emotional health problems in children, says a new study.
Dutch researchers report that the children of mothers who took folic acid supplements during pregnancy were better at internalising and externalising problems, compared to the children of mothers who did not take supplements, according to findings published in the British Journal of Nutrition.
The research adds to the mother and child benefits of folic acid, in addition to the established link at reducing the incidence of neural tube defects (NTDs).
An overwhelming body of evidence links has linked folate deficiency in early pregnancy to increased risk of NTDs - most commonly spina bifida and anencephaly - in infants.
This connection led to the 1998 introduction of public health measures in the US and Canada, where all grain products are fortified with folic acid - the synthetic, bioavailable form of folate.
Preliminary evidence indicates that the measure is having an effect with a reported 15 to 50 per cent reduction in NTD incidence. In Chile, the measure has been associated with a 40 per cent reduction in NTDs. A total of 51 countries now have some degree of mandatory fortification of flour with folic acid.
The new study, led by Henning Tiemeier from Erasmus MC University Medical Center Rotterdam, indicates that the behaviour of the offspring may also be improved.
The researchers assessed the folic acid supplement use of the mothers of 4,214 toddlers during the first trimester of pregnancy using a questionnaire. The children underwent a behavioural test at age 18 months.
According to their findings, “children of mothers who did not use folic acid supplements in the first trimester had a higher [44 per cent] risk of total problems”.
Children of folic acid-using mothers were protected from internalising and externalising their problems, even when the researchers took into account their mothers’ characteristics.
Commenting on the potential mechanism, the researchers note several potential mechanisms including the role of folates on the direct development of the central nervous system. The vitamin plays a key role in the production of brain cells, and has also been linked to the synthesis of various neurotransmitters.
Another possible mechanism is how folate indirectly effects foetal growth, noting that folic acid supplements have been linked to heavier babies, and that a lower birth weight has previously been linked to to behavioural and emotional problems.
“Inadequate use of folic acid supplements during early pregnancy may be associated with a higher risk of behavioural problems in the offspring,” wrote the researchers.
“Folic acid supplementation in early pregnancy, aimed to prevent neural tube defects, may also reduce mental health problems in children,” they concluded.
Source: British Journal of Nutrition
Published online ahead of print, doi:10.1017/S0007114509991954
“Maternal folic acid supplement use in early pregnancy and child behavioural problems: The Generation R Study”
Authors: S.J. Roza, T. van Batenburg-Eddes, E.A.P. Steegers, V.W.V. Jaddoe, J.P. Mackenbach, A. Hofman, F.C. Verhulst, H. Tiemeier