Maternal use of folic acid supplements during pregnancy and four-year-old neurodevelopment in a population-based birth cohort

Paediatr Perinat Epidemiol. 2009 May;23(3):199-206. doi: 10.1111/j.1365-3016.2009.01032.x. Epub 2009 Mar 11.


The use of folic acid supplements during very early pregnancy is recommended in order to reduce the incidence of neural tube defects. Little is known about the possible benefits of folic acid on child neurodevelopment. A total of 420 children (87% of those eligible) from a birth cohort had complete data for final analyses at age 4 years. Information about folic acid and other over-the-counter dietary supplements was obtained prospectively using interviewer-administered questionnaires at the end of the first trimester of pregnancy. Psychological outcomes were assessed by two psychologists and teachers 4 years later. Low maternal socio-economic status, smoking, high parity and short duration of breast feeding were associated with lower prevalence of folic acid supplement use. Verbal (b = 3.98, SE = 1.69), motor (b = 4.54, SE = 1.66) and verbal-executive function (b = 3.97, SE = 1.68) scores, social competence (b = 3.97, SE = 1.61) and inattention symptom [OR = 0.46; 95% CI 0.22, 0.95] scores were associated with reported folic acid use. Reported folic acid supplement use during pregnancy was associated with improved neurodevelopment in children after adjusting for a number of sociodemographic and behavioural factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child Development / physiology*
  • Child, Preschool
  • Cohort Studies
  • Dietary Supplements*
  • Female
  • Folic Acid / administration & dosage*
  • Humans
  • Infant
  • Neural Tube Defects / prevention & control*
  • Neurologic Examination
  • Pregnancy
  • Prenatal Care / methods
  • Prenatal Exposure Delayed Effects
  • Prenatal Nutritional Physiological Phenomena / physiology*
  • Socioeconomic Factors
  • Spain
  • Time Factors
  • Vitamins / administration & dosage*


  • Vitamins
  • Folic Acid