Mental health

June 2011

Research

Folic acid in pregnancy

Is there a link with childhood asthma or wheeze?

Volume 40, No.6, June 2011 Pages 421-424

Eleanor Sharland

Brett David Montgomery

Raquel Granell

Background

Folic acid supplementation has an established role in early pregnancy for preventing neural tube defects. However, there is controversy over a possible link between late pregnancy folic acid supplementation and childhood asthma.

Objective/s

To review the evidence exploring the association between maternal folate exposure in pregnancy and childhood asthma or wheeze.

Results

Four relevant observational studies were identified. Two found statistically significant associations between childhood asthma and late (but not early) pregnancy maternal folic acid exposure. Another found a statistically significant association between childhood wheeze and early (but not late) pregnancy maternal folic acid exposure. A fourth study found little association between maternal dietary folate in pregnancy and infantile wheeze.

Discussion

The currently available evidence regarding an association between folate in pregnancy and childhood asthma or wheeze is conflicting. We offer suggestions for discussing the potential risk with patients and recommend further research on this subject be conducted.

Folate is a water soluble B vitamin that must be obtained in the diet or through supplementation. For more than 50 years it has been known that folate plays an integral role in embryonic development.1 Periconceptional folic acid in doses of at least 0.36 mg has been shown to prevent approximately 72% of neural tube defects,2,3 and therefore a daily dose of 0.4 mg is widely recommended for all women at average risk from at least 1 month preconception to 12 weeks pregnancy.4 Despite this, many Australian women do not have sufficient folate intake in pregnancy,5 thus mandatory folic acid fortification of flour was introduced in Australia in September 2009.6

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Correspondence afp@racgp.org.au

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