Reducing Risk for Autism Spectrum Disorder: Vitamins, Folic Acid Use During Pregnancy

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Reduced risk for autism in offspring, a consideration for public health policy, may be achieved with extended use of folic acid and multivitamin supplements during pregnancy.
Reduced risk for autism in offspring, a consideration for public health policy, may be achieved with extended use of folic acid and multivitamin supplements during pregnancy.

Maternal use of folic acid and multivitamin supplements before and during pregnancy were associated with a reduced risk for autism spectrum disorder in offspring, according to findings published in JAMA Psychiatry.

In this case-control cohort study, 45,300 Israeli children born between 2003 and 2007 were enrolled and evaluated for autism spectrum disorder from birth to a mean (standard deviation) age of 10.0 (1.4) years. Children diagnosed with autism spectrum disorder were compared with a random sample of 33% of live-born children serving as controls. The association between maternal vitamin supplementation exposure and risk for autism spectrum disorder in offspring was evaluated.

A total of 1.3% of children in the study were diagnosed with autism spectrum disorder (n=572).

Maternal use of folic acid and/or multivitamin supplements before pregnancy (relative risk [RR], 0.39; P <.001) and during pregnancy (RR, 0.27; P <.001) were significantly associated with a reduced risk for autism spectrum disorder in offspring compared with no vitamin use. Similarly, maternal use of folic acid before pregnancy (RR, 0.56; P =.001) and during pregnancy (RR, 0.32; P <.001) were associated with lower risks for autism spectrum disorder in offspring, as were the use of multivitamin supplements before pregnancy (RR, 0.36; P <.001) and during pregnancy (RR, 0.35; P <.001).

Comparison of vitamin use before and during pregnancy did not reveal significant differences in autism spectrum disorder risk in offspring. Maternal use in the 2-year period before pregnancy significantly reduced the risk for autism spectrum disorder in offspring compared with no exposure, no exposure during the 2 years before pregnancy, and no exposure during pregnancy.

The study authors concluded that "[m]aternal [folic acid] and/or multivitamin supplement exposure before and during pregnancy reduced the risk of [autism spectrum disorder] in offspring.... Reduced risk of [autism spectrum disorder] in offspring is a consideration for public health policy that may be realized by extended use of [folic acid] and multivitamin supplements during pregnancy."

Reference

Levine SZ, Kodesh A, Viktorin A, et al. Association of maternal use of folic acid and multivitamin supplements in the periods before and during pregnancy with the risk of autism spectrum disorder in offspring [published online January 3, 2018]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2017.4050

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