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In this study, researchers measured folic acid blood levels in 4,934 women in early pregnancy (less than 18 weeks) and the women filled out questionnaires about folic acid and/or multivitamin supplement use. When their children were three years old, the women answered questions about their child’s behavioral and emotional health.
Of the 3,209 children that they received data about, women with the lowest folate blood levels had a 57% higher risk of having a child with emotional problems (including emotional reactivity, anxious or depressed symptoms, or symptoms of being withdrawn) compared with women with the highest folate levels. Starting folic acid late in pregnancy or not taking folic acid supplements also increased the risk compared with women who started folic acid supplementation before pregnancy.
The study authors cautioned that while their results suggest folic acid supplementation in women may decrease their child’s risk of emotional problems, folic acid may not be the only factor, and that “not only high socioeconomic status, but also better home environment or other indicators of social status, which are associated with higher plasma folate concentrations” may contribute to whether or not a child develops emotional problems.
Further research is needed to understand the role of folic acid in children’s emotional and behavioral health.
It is well established that women of childbearing age who take folic acid supplements lower their risk of having a child born with neural tube defects such as spina bifida. And in fact, public awareness of the benefits of folic acid has helped reduce the rate of such defects.
Unfortunately, throughout the world, not all women take or have access to folic acid supplements during pregnancy. The study authors comment that despite campaigns to promote folic acid supplementation in the Netherlands, about half of the women do not use folic acid supplements as recommended. They add that folic acid added to foods (fortification) can help women of childbearing age, but it is not enough, and emphasize the importance of supplementation.
Continued education and access to supplements is needed for all women who may become pregnant. If you are a woman of childbearing age or pregnant, talk with a doctor about how much folic acid you should be getting on a daily basis and about other important nutrients and supplements that may help optimize a baby’s health.
(Am J Clin Nutr 2012;95:1413–21)