Folic acid immense role on mental health of infant: a review

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Folic acid’s most well-known benefit for a healthy pregnancy is helping prevent spinal cord defects. Specifically, folic acid fortification of our food supply has helped reduced neural tube defects by 23% in the 1990’s (1).  The current folic acid fortification guidelines are 0.14 mg of folic acid per 100 grams of cereal grain, which is designed to produce an increased intake of 0.2 mg of folic acid per day (2).  Research has suggested that 5 mg of folic acid per day can decrease the risk of neural-tube defects by 85% in women, with the current recommendations by the National Institutes of Health ranging from 0.15 mg per day in infants to 0.5 mg per day in lactating women (3).

Now a new study (4) has suggested that folic acid intake during pregnancy may also play a role in mental health of the infant.  In the study, blood samples were collected from 100 women before their 17th week of pregnancy.  Throughout the rest of their pregnancy, the women provided information about their intake of 100 foods, using a food frequency questionnaire. In addition to having their infant’s weight and head circumference measured at birth and at 9 months of age, the mothers returned with their children at age 8 years and completed the Strengths and Difficulties Questionnaire (5).  This provided feedback regarding hyperactivity, emotional symptoms, conduct problems, and peer problems.

The researchers found that blood levels of folic acid during pregnancy was directly correlated to hyperactivity in the children.  Specifically, children of mothers with the lowest intake of folic acid (as low as 328 micrograms per day) in early pregnancy (up to 14 weeks) had significantly higher scores (hence, more problems) regarding hyperactivity and peer problems than children of mothers with the highest intake of folic acid in early pregnancy (as high as 624 micrograms per day).  Emotional symptoms and conduct scores were not significantly different between the groups.

For the researchers, “our data provide preliminary support for the hypothesis that lower folate status in early pregnancy might impair fetal brain development and affect hyperactivity/inattention and peer problems in childhood.” 

The researchers also push for a higher folic acid fortification of the food supply to produce an intake of at least 0.6 mg per day since that amount has been shown to lower homocysteine levels by about 3 mmol per liter, a decrease that results in a 15% reduced risk of heart attack and a 25% reduced risk of stroke, deep venous thrombosis, and pulmonary embolism (6)

Reference:

1.

Shaw GM.  Choline and risk of neural tube defects in a folate-fortified population.  Epidemiology. 2009 Sep;20(5):714-9.
 2. Wald NJ.  Folic Acid and the Prevention of Neural-Tube Defects.  NJEM 2004; 350(2):101-103
 3. “Dietary Supplement Fact Sheet: Folate” posted on http://dietary-supplements.info.nih.gov/factsheets/folate.asp
 4. Schlotz W.  Lower maternal folate status in early pregnancy is associated with childhood hyperactivity and peer problems in offspring.  Jou Child Psychol Psych 2009.  Published Online: Oct 28 2009 6:11AM.  DOI: 10.1111/j.1469-7610.2009.02182.x
 5. Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38, 581–586
 6. Wald DS, Law M, Morris JK. Homocysteine and cardiovascular disease: evidence on causality from a meta-analysis. BMJ 2002;325:1202-1202

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