Examining associations of folic acid supplements administered to mothers during pre-conceptional and prenatal periods with autism spectrum disorders in their offspring: insights from a multi-center study in China

Front Public Health. 2024 Jan 17:12:1321046. doi: 10.3389/fpubh.2024.1321046. eCollection 2024.

Abstract

Objective: To investigate the relationship between maternal folic acid (FA) supplementation during the pre-conceptional and prenatal periods and the subsequent risk of autism spectrum disorder (ASD) in offspring.

Methods: A total of 6,049 toddlers aged 16-30 months were recruited from August 2016 to March 2017 for this cross-sectional study conducted in China. The parents of the enrolled toddlers provided information on maternal supplemental FA, socio-demographic information, and related covariates. Standard diagnostic procedures were implemented to identify toddlers with ASD.

Results: Among the 6,049 children included in the study, consisting of 3,364 boys with an average age of 22.7 ± 4.1 months, a total of 71 children (1.2%) were diagnosed with ASD. Mothers who did not consume FA supplements during the prenatal period were found to have a significantly increased risk of having offspring with ASD, in comparison to those who were exposed to FA supplements (odds ratio [OR] = 2.47). However, we did not find a similar association during the pre-conceptional period. Compared to mothers who consistently used FA supplements from pre-conception to the prenatal period, those who never used FA supplements were statistically significantly associated with a higher risk of ASD in their offspring (OR = 2.88).

Conclusion: This study indicated that providing continuous maternal FA supplementation during the pre-conceptional and prenatal periods may decrease the risk of ASD in offspring. The prenatal period is considered to be the most crucial time for intervention.

Keywords: autism spectrum disorder; environmental factor; folic acid; pre-conceptional period; prenatal period.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autism Spectrum Disorder* / epidemiology
  • Autism Spectrum Disorder* / etiology
  • Child, Preschool
  • China / epidemiology
  • Cross-Sectional Studies
  • Dietary Supplements / adverse effects
  • Female
  • Folic Acid* / adverse effects
  • Humans
  • Infant
  • Male
  • Pregnancy
  • Vitamins

Substances

  • Folic Acid
  • Vitamins

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was funded by Guangdong Basic and Applied Basic Research Foundation (2020A1515111096 and 2022B1515130007), the Key-Area Research and Development Program of Guangdong Province (2019B030335001), and the National Natural Science Foundation of China (81872639, 82103794, and 81973063).