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Updated: Sep 9, 2025
Author Spotlight: Studying the Impact of Maternal Dietary Deficiencies on Long-Term Offspring Health Outcomes
Published on: June 28, 2024
Association between maternal folic acid supplementation in different pregnancy and infant neurobehavioral development
Maoyuan Yang1,2,3,4,5, Zengyao Wang6, Ke Zhou1
1School of Public Health, Anhui Medical University, Hefei, Anhui, China.
Insights
Maternal folic acid (FA) supplementation during pregnancy, especially in the second and third trimesters, is linked to improved infant neurobehavioral development. Continued FA intake supports communication, fine motor skills, and problem-solving abilities in infants.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Neurology
- Nutritional Science
Background:
- Periconceptional folic acid (FA) supplementation is established for preventing neural tube defects.
- The impact of FA supplementation during later pregnancy stages on infant neurobehavioral development requires further clarification.
Purpose of the Study:
- To investigate the association between maternal FA supplementation at various pregnancy stages and infant neurobehavioral development.
- To specifically examine the effects of continued FA supplementation during the second and third trimesters.
Main Methods:
- Prospective birth cohort study of 3246 parent-child pairs.
- Neurobehavioral development assessments at 6 and 18 months.
- Multivariable logistic regression and propensity score analysis to evaluate FA supplementation's impact on developmental delays.
Main Results:
- Periconceptional FA supplementation was associated with reduced risk of communication delays in 18-month-olds.
- Continuous FA supplementation in the second and third trimesters linked to decreased risk of fine motor and problem-solving delays in 6-month-olds.
- Associations remained significant after adjusting for confounders and propensity scores.
Conclusions:
- Maternal FA supplementation across different pregnancy stages may positively influence offspring neurobehavioral development.
- Further research with larger sample sizes and consistent folate status monitoring is recommended to confirm these findings.
Background:
It has been proven that periconceptional folic acid (FA) supplementation could prevent neural tube defects. However, FA supplementation during different stages of pregnancy and its association with the neurobehavioral development of offspring remains unclear, particularly the effects of continued FA supplementation during the second and third trimesters. This study aimed to investigate the relationship between maternal FA supplementation at various stages of pregnancy and infant neurobehavioral development.
Methods:
In a prospective birth cohort study involving 3246 parent-child pairs, 2905 infants completed neurobehavioral development assessments at 6 months and 3005 infants at 18 months. Information regarding micronutrient supplementation at various stages of pregnancy was recorded. Multivariable logistic regression was used to evaluate the association between FA supplementation and infant neurobehavioral developmental delays. In addition, propensity score analysis was performed to correct the potential imbalances in the distribution of related factors between the groups.
Results:
During the periconceptional period, maternal standardized FA supplementation (taking 0.4 mg FA daily before and in early pregnancy, as officially recommended) was associated with a reduced risk of possible development delays in 18-month-old infants in the communication domain (RR = 0.48, 95% CI: 0.26-0.86; P = 0.015). After the 12th gestational week, maternal continuous FA supplementation in the second and third trimesters was significantly associated with a decreased risk of possible neurobehavioral development delay in 6-month-old infants in fine motor domain (RR = 0.31, 95% CI: 0.12-0.82; P = 0.019) and the problem-solving domain (RR = 0.20, 95% CI: 0.05-0.79; P = 0.022). These associations remained significant after adjusting for confounders and propensity scores.
Conclusions:
FA supplementation at different stages of pregnancy may enhance neurobehavioral development in offspring. To confirm these findings, additional investigations or trials with larger sample sizes and consistent tracking of folate status throughout pregnancy are recommended.
