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Updated: May 31, 2026

Modifying Levels of Maternal Dietary Folic Acid or Choline to Study the Impact of Deficiencies on Offspring Health Outcomes
Published on: June 28, 2024
Positional plagiocephaly and excessive folic acid intake during pregnancy
Alice C Michels1, Marijke E Van den Elzen, J S H Vles
1Plastic and Reconstructive Surgery Department, Academic Hospital Maastricht, Maastricht, The Netherlands. Alicemichels@yahoo.com
Objective:
To assess the relationship between high intake of folic acid and positional plagiocephaly.
Design:
Retrospective case-control study with questionnaires administered in the clinic to biological mothers of children with positional plagiocephaly (PP group) and mothers of children without it (CO group).
Setting:
Tertiary, institutional clinic. University Hospital of Maastricht, The Netherlands.
Exclusion Criteria:
mothers of children with syndromic disease or bone deformation and of children with clearly continuous forces on the skull (torticollis). A total of 94 mothers were included in the PP group (response rate: 85%), and 74 were included in the CO group (response rate: 75%). Final sample sizes were 75 in the PP group and 54 in the CO group.
Main Outcome Measures:
The recommended daily dosage of folic acid in The Netherlands is 400 µg. The primary outcome was folic acid dosage in relation to the recommended dosage. A secondary outcome was duration of folic acid intake in relation to the recommended period of use during pregnancy.
Results:
In the PP group, 20% used double the recommended dosage of folic acid, compared with 6% in the CO group (p < .05). In the CO group, 59% used folic acid longer than recommended compared with 56% in the PP group (not significant). There were no differences in baseline characteristics except for gestational period: 39.5 weeks in the PP group and 37.9 in the CO group (p < .05).
Conclusion:
Excessive daily intake of folic acid during pregnancy is seen among mothers of positional plagiocephaly patients.
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