Haifa, Israel—A promising new study suggests the use of folic acid and multivitamin supplements by women before and during pregnancy was associated with a lower likelihood of autism spectrum disorder (ASD) in children. Study authors caution, however, that the results should be interpreted with caution because other factors could explain it.

The report in JAMA Psychiatry notes that previous research looking at the association between maternal use of folic acid and multivitamin supplements and risk of ASD in children have been inconsistent.

For this study, led by Israeli researchers from the University of Haifa, records for 45,300 Israeli children born between 2003 and 2007 were analyzed and followed up to 2015. The focus was on exposure, defined as maternal use of folic acid and multivitamin supplements before and during pregnancy, and outcome, defined as development of ASD.

Maternal use of folic acid and multivitamin supplements before and during pregnancy appeared to be associated with a reduced risk for ASD in children compared with the children of mothers who did not use supplements.

By the end of follow-up, 1.3% of the children had received a diagnosis of ASD. Results indicate that maternal exposure to folic acid and/or multivitamin supplements before pregnancy was statistically significantly associated with a lower likelihood of ASD in the offspring compared with no exposure before pregnancy (RR, 0.39; 95% CI, 0.30-0.50; P <.001). In addition, maternal exposure to folic acid and/or multivitamin supplements during pregnancy was statistically significantly associated with a lower likelihood of ASD in offspring compared with no exposure during pregnancy (RR, 0.27; 95% CI, 0.22-0.33; P <.001).

Researchers estimated corresponding RRs for maternal exposure to folic acid before pregnancy (RR, 0.56; 95% CI, 0.42-0.74; P = .001); maternal exposure to folic acid during pregnancy (RR, 0.32; 95% CI, 0.26-0.41; P <.001); maternal exposure to multivitamin supplements before pregnancy (RR, 0.36; 95% CI, 0.24-0.52; P <.001); and maternal exposure to multivitamin supplements during pregnancy (RR, 0.35; 95% CI, 0.28-0.44; P <.001). The results generally remained statistically significant across sensitivity analyses, they said.

“Maternal exposure to folic acid and multivitamin supplements before and during pregnancy is associated with a reduced risk of ASD in the offspring compared with the offspring of mothers without such exposure,” study authors conclude, adding that, because of the type of study, they cannot rule out that the risk reduction is due to other causes.
   
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