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Shereen Jegtvig, MS

Could Folic Acid Reduce the Risk of Autism?

By February 13, 2013

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According to a study published today by the Journal of the American Medical Association (JAMA), folic acid may be associated with a lower risk of autism. A study published this week found that women who took folic acid (the supplemental form of folate, a B-complex vitamin) had fewer children who were diagnosed with autism. The study ran from 2002 to 2012 and included about 85,000 children.

According to the numbers from the press release, periconceptual folic acid use by the mothers would have a relative risk of about 0.76 (a relative risk below 1.0 means that whatever it is you're looking at appears to have some protective benefit), and would probably be statistically significant. But very few children in either group were diagnosed with autism. Only 0.10% of children vs. about 0.21%, so the actual clinical benefit is pretty small. Also, this benefit was only seen when women took the folic acid around they time they conceived; there wasn't any benefit if they didn't start taking the folic acid in the middle of the pregnancy.

As with any large population study, there may be other reasons for the results and not specifically the one being studied. In this case, the mothers had fewer autistic children may have had other things in common that affect autism risk. According to the study, the women who used folic acid within the exposure interval were also more likely to have college- or university-level education, to have planned the pregnancy, to be nonsmokers, to have a pre-pregnancy body mass index below 25, and to be first-time mothers. Another important note: a study like this only shows a correlation between folic acid intake and risk of autism, it doesn't prove that folate deficiency causes autism, or that taking folic acid will provide any benefit to children who have autism.

Folic Acid Fortification

Fortification of foods with folic acid is already common in many countries because it's understood that an adequate intake of folate/folic acid around the time of conception reduces the risk of spina bifida, a congenital spinal deformity. Women are are thinking about becoming pregnant are urged to increase their intake of folate-rich foods (it's naturally found in green vegetables, orange, strawberries and legumes) or take a folic acid supplement.
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