Effect of maternal high dosages of folic acid supplements on neurocognitive development in children at 4-5 y of age: the prospective birth cohort Infancia y Medio Ambiente (INMA) study
The benefits of the use of folic acid supplements (FASs) during the periconception period to prevent neural tube defects and to ensure normal brain development in offspring are well known. There is concern, however, about the long-term effects of the maternal use of high dosages of FASs that exceed...
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| Vydáno v: | The American journal of clinical nutrition Ročník 106; číslo 3; s. 878 |
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01.09.2017
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| ISSN: | 1938-3207, 1938-3207 |
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| Abstract | The benefits of the use of folic acid supplements (FASs) during the periconception period to prevent neural tube defects and to ensure normal brain development in offspring are well known. There is concern, however, about the long-term effects of the maternal use of high dosages of FASs that exceed the Tolerable Upper Intake Level (UL) (≥1000 μg/d) on child neurocognitive outcomes.
The objective of the study was to examine the association between the use of high dosages of FASs during pregnancy and child neuropsychological development at ages 4-5 y.
The multicenter prospective mother-child cohort study, the Infancia y Medio Ambiente (INMA) Project, was conducted in 4 regions of Spain: Asturias, Sabadell, Gipuzkoa, and Valencia. Pregnant women were recruited between 2003 and 2008. Data on 1682 mother-child pairs were included in the final analyses. The pregnant women completed an interviewer-administered questionnaire that was validated to estimate typical dietary folate intake and the use of FASs at 10-13 and 28-32 wk of gestation. Neuropsychological development scores at 4-5 y of age were estimated with the use of the McCarthy Scales of Children's Abilities. Multiple linear regression and meta-analysis were used to obtain combined-effect estimates.
During the periconception period, one-third of the women (
= 502) took FAS dosages ≥1000 μg/d. The use of FAS dosages ≥1000 μg/d in this period was negatively associated with several neuropsychological outcomes scores in children: global verbal (β = -2.49; 95% CI: -4.71, -0.27), verbal memory (β = -3.59; 95% CI: -6.95, -0.23), cognitive function of posterior cortex (β = -2.31; 95% CI: -4.45, -0.18), and cognitive function of left posterior cortex (β = -3.26; 95% CI: -5.51, -1.01).
The use of FAS dosages exceeding the UL (≥1000 μg/d) during the periconception period was associated with lower levels of cognitive development in children aged 4-5 y. The use of FAS dosages ≥1000 μg/d during pregnancy should be monitored and prevented as much as possible, unless medically prescribed. |
|---|---|
| AbstractList | The benefits of the use of folic acid supplements (FASs) during the periconception period to prevent neural tube defects and to ensure normal brain development in offspring are well known. There is concern, however, about the long-term effects of the maternal use of high dosages of FASs that exceed the Tolerable Upper Intake Level (UL) (≥1000 μg/d) on child neurocognitive outcomes.
The objective of the study was to examine the association between the use of high dosages of FASs during pregnancy and child neuropsychological development at ages 4-5 y.
The multicenter prospective mother-child cohort study, the Infancia y Medio Ambiente (INMA) Project, was conducted in 4 regions of Spain: Asturias, Sabadell, Gipuzkoa, and Valencia. Pregnant women were recruited between 2003 and 2008. Data on 1682 mother-child pairs were included in the final analyses. The pregnant women completed an interviewer-administered questionnaire that was validated to estimate typical dietary folate intake and the use of FASs at 10-13 and 28-32 wk of gestation. Neuropsychological development scores at 4-5 y of age were estimated with the use of the McCarthy Scales of Children's Abilities. Multiple linear regression and meta-analysis were used to obtain combined-effect estimates.
During the periconception period, one-third of the women (
= 502) took FAS dosages ≥1000 μg/d. The use of FAS dosages ≥1000 μg/d in this period was negatively associated with several neuropsychological outcomes scores in children: global verbal (β = -2.49; 95% CI: -4.71, -0.27), verbal memory (β = -3.59; 95% CI: -6.95, -0.23), cognitive function of posterior cortex (β = -2.31; 95% CI: -4.45, -0.18), and cognitive function of left posterior cortex (β = -3.26; 95% CI: -5.51, -1.01).
The use of FAS dosages exceeding the UL (≥1000 μg/d) during the periconception period was associated with lower levels of cognitive development in children aged 4-5 y. The use of FAS dosages ≥1000 μg/d during pregnancy should be monitored and prevented as much as possible, unless medically prescribed. Background: The benefits of the use of folic acid supplements (FASs) during the periconception period to prevent neural tube defects and to ensure normal brain development in offspring are well known. There is concern, however, about the long-term effects of the maternal use of high dosages of FASs that exceed the Tolerable Upper Intake Level (UL) (≥1000 μg/d) on child neurocognitive outcomes.Objective: The objective of the study was to examine the association between the use of high dosages of FASs during pregnancy and child neuropsychological development at ages 4-5 y.Design: The multicenter prospective mother-child cohort study, the Infancia y Medio Ambiente (INMA) Project, was conducted in 4 regions of Spain: Asturias, Sabadell, Gipuzkoa, and Valencia. Pregnant women were recruited between 2003 and 2008. Data on 1682 mother-child pairs were included in the final analyses. The pregnant women completed an interviewer-administered questionnaire that was validated to estimate typical dietary folate intake and the use of FASs at 10-13 and 28-32 wk of gestation. Neuropsychological development scores at 4-5 y of age were estimated with the use of the McCarthy Scales of Children's Abilities. Multiple linear regression and meta-analysis were used to obtain combined-effect estimates.Results: During the periconception period, one-third of the women (n = 502) took FAS dosages ≥1000 μg/d. The use of FAS dosages ≥1000 μg/d in this period was negatively associated with several neuropsychological outcomes scores in children: global verbal (β = -2.49; 95% CI: -4.71, -0.27), verbal memory (β = -3.59; 95% CI: -6.95, -0.23), cognitive function of posterior cortex (β = -2.31; 95% CI: -4.45, -0.18), and cognitive function of left posterior cortex (β = -3.26; 95% CI: -5.51, -1.01).Conclusions: The use of FAS dosages exceeding the UL (≥1000 μg/d) during the periconception period was associated with lower levels of cognitive development in children aged 4-5 y. The use of FAS dosages ≥1000 μg/d during pregnancy should be monitored and prevented as much as possible, unless medically prescribed.Background: The benefits of the use of folic acid supplements (FASs) during the periconception period to prevent neural tube defects and to ensure normal brain development in offspring are well known. There is concern, however, about the long-term effects of the maternal use of high dosages of FASs that exceed the Tolerable Upper Intake Level (UL) (≥1000 μg/d) on child neurocognitive outcomes.Objective: The objective of the study was to examine the association between the use of high dosages of FASs during pregnancy and child neuropsychological development at ages 4-5 y.Design: The multicenter prospective mother-child cohort study, the Infancia y Medio Ambiente (INMA) Project, was conducted in 4 regions of Spain: Asturias, Sabadell, Gipuzkoa, and Valencia. Pregnant women were recruited between 2003 and 2008. Data on 1682 mother-child pairs were included in the final analyses. The pregnant women completed an interviewer-administered questionnaire that was validated to estimate typical dietary folate intake and the use of FASs at 10-13 and 28-32 wk of gestation. Neuropsychological development scores at 4-5 y of age were estimated with the use of the McCarthy Scales of Children's Abilities. Multiple linear regression and meta-analysis were used to obtain combined-effect estimates.Results: During the periconception period, one-third of the women (n = 502) took FAS dosages ≥1000 μg/d. The use of FAS dosages ≥1000 μg/d in this period was negatively associated with several neuropsychological outcomes scores in children: global verbal (β = -2.49; 95% CI: -4.71, -0.27), verbal memory (β = -3.59; 95% CI: -6.95, -0.23), cognitive function of posterior cortex (β = -2.31; 95% CI: -4.45, -0.18), and cognitive function of left posterior cortex (β = -3.26; 95% CI: -5.51, -1.01).Conclusions: The use of FAS dosages exceeding the UL (≥1000 μg/d) during the periconception period was associated with lower levels of cognitive development in children aged 4-5 y. The use of FAS dosages ≥1000 μg/d during pregnancy should be monitored and prevented as much as possible, unless medically prescribed. |
| Author | Tardón, Adonina Navarrete-Muñoz, Eva M González-Safont, Llúcia Ibarluzea, Jesús Romaguera, Dora Balluerka, Nekane Vioque, Jesús Valera-Gran, Desirée Fernández-Somoano, Ana Murcia, Mario Julvez, Jordi Garcia de la Hera, Manuela |
| Author_xml | – sequence: 1 givenname: Desirée surname: Valera-Gran fullname: Valera-Gran, Desirée organization: Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain – sequence: 2 givenname: Eva M surname: Navarrete-Muñoz fullname: Navarrete-Muñoz, Eva M organization: Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain – sequence: 3 givenname: Manuela surname: Garcia de la Hera fullname: Garcia de la Hera, Manuela organization: Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain – sequence: 4 givenname: Ana surname: Fernández-Somoano fullname: Fernández-Somoano, Ana organization: Department of Preventive Medicine and Public Health, University of Oviedo, Oviedo, Spain – sequence: 5 givenname: Adonina surname: Tardón fullname: Tardón, Adonina organization: Department of Preventive Medicine and Public Health, University of Oviedo, Oviedo, Spain – sequence: 6 givenname: Jesús surname: Ibarluzea fullname: Ibarluzea, Jesús organization: Health Research Institute (BIODONOSTIA), San Sebastian, Spain – sequence: 7 givenname: Nekane surname: Balluerka fullname: Balluerka, Nekane organization: Department of Social Psychology and Behavioral Sciences Methods, University of the Basque Country, San Sebastian, Spain – sequence: 8 givenname: Mario surname: Murcia fullname: Murcia, Mario organization: FISABIO-University of Valencia-University Jaume I Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain – sequence: 9 givenname: Llúcia surname: González-Safont fullname: González-Safont, Llúcia organization: FISABIO-University of Valencia-University Jaume I Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain – sequence: 10 givenname: Dora surname: Romaguera fullname: Romaguera, Dora organization: Spanish Consortium for Research on Obesity and Nutrition (CIBEROBN), Madrid, Spain – sequence: 11 givenname: Jordi surname: Julvez fullname: Julvez, Jordi organization: ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; and – sequence: 12 givenname: Jesús orcidid: 0000-0002-2284-148X surname: Vioque fullname: Vioque, Jesús email: vioque@umh.es organization: Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain |
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| SubjectTerms | Adult Brain - drug effects Child Development - drug effects Child, Preschool Cognition - drug effects Diet Diet Surveys Dietary Supplements - adverse effects Female Folic Acid - administration & dosage Folic Acid - adverse effects Humans Male Memory - drug effects Pregnancy Prenatal Exposure Delayed Effects Prenatal Nutritional Physiological Phenomena Prospective Studies Spain Vitamin B Complex - administration & dosage Vitamin B Complex - adverse effects |
| Title | Effect of maternal high dosages of folic acid supplements on neurocognitive development in children at 4-5 y of age: the prospective birth cohort Infancia y Medio Ambiente (INMA) study |
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