More reason to take folic acid while pregnant

By Piriya Mahendra

Taking folic acid supplements during pregnancy can significantly reduce the likelihood for babies being born with cleft lip and palate, researchers say.

Health practitioners should be made aware of the growing number of benefits of folic acid and reinforce the importance of folic acid supplement education as part of prenatal counseling, write Tom O'Dowd (Trinity College Dublin, Ireland) and colleagues in the British Journal of General Practice.

Their large, population-based study showed that among women who did not take folic acid supplements during the first 3 months of pregnancy, the rate of cleft lip and palate was 6.8 per 1000 9-month-old infants.

By contrast, the rate was much lower among the infants of women who did take folic acid during this time, at 1.5 per 1000 infants.

Regression analysis showed that omitting to take folic acid during the first 3 months of pregnancy was linked to a 4.36-fold increased rate of cleft lip and palate.

In multivariate analysis adjusted for maternal education, age, and occupational household class, among other variables, this odds ratio was even higher, at 4.52.

The cohort study involved 11,134 9-month-old infants from the Growing Up in Ireland study.

The authors point out that women who did not take folic acid supplements before becoming pregnant had no significantly increased risk for cleft lip in their babies.

Current European recommendations state that women planning pregnancy should use a folic acid supplement of 400 µg per day from at least 4 weeks before, until 12 weeks after conception.

However, the consumption of folic acid was suboptimal in 36.3% of the women in their study, say the authors, with nonadherence being more common in people with a low socioeconomic status.

"This study supports the hypothesis that folic acid supplements play a significant role in preventing cleft lip and palate when taken in the first 12 weeks of pregnancy," they remark.

"This information is particularly pertinent to GPs as they are usually the first point of contact for women who are trying to conceive or in the very early stages of pregnancy."

The authors conclude: "This study suggests that folic acid plays a major role in preventing a major birth defect and, in addition, it offers established protection against neural tube defects."

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