Folic acid is always recommended to pregnant women because of its importance to the developing fetus. Deficiency increases the risk of neural tube defects, such as spina bifida, and it can damage gene expression, leading to problems with brain development. Most of the research on this topic has been related to the effect of maternal folate deficiency on newborns. This study is unique because it evaluated the longer-term consequences of maternal folate deficiency on children who are now six to eight years old. It is also more advanced than previous studies because of the testing methods; folate was measured in the form of 5-MTHF, the active and most significant form. They also measured homocysteine levels, a marker for cardiovascular disease that is strongly correlated with folic acid and B12 status.

This study was conducted in the Netherlands, where dietary standards are higher than in most countries. They evaluated 256 children between ages 6 and 8. Folate deficiency was found in 62 of the mothers in early stages of pregnancy. Researchers evaluated the children’s cognitive performance, psychological/behavioral problems, language skills, visual spatial tests, and brain volume.

Children born with low folate levels were found to have smaller brain volume and scored lower on language testing and visual spatial tests. High homocysteine levels in mothers was related to lower language and visual spatial tests. Psychological and behavior issues were not related to folate or homocysteine status.

Folate deficiency can be caused by inadequate intake through diet or supplementation. But one of the especially interesting findings in this study was that one-third of the mothers who were low in 5-MTHF were actually taking regular folate supplements. This may indicate that they were unable to properly metabolize the folic acid in it due to genetic mutations. People with a MTHF genetic defect need to take folic acid in the form of 5-MTHF because they are unable to metabolize the more common form properly.

Previous research has correlated high maternal folate levels with higher levels of intelligence. This study has helped confirm the importance of folate status, and will hopefully inspire women not only to take a folic acid supplement, but also to test for the genetic defect prior to pregnancy in order to know which form they require.

British Journal of Nutrition DOI: S0007114515005383 (About DOI),

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