A new preliminary study suggests that taking higher doses of folic acid during the first trimester of pregnancy may offer significant benefits for the verbal and behavioral skills of children at age six, with no evidence of negative effects. This study, which will be presented at the American Academy of Neurology’s 77th Annual Meeting in San Diego and online from April 5–9, 2025, provides promising insights into the role of folic acid in early pregnancy and child brain development.
Folic acid has long been known to reduce deformities and improve intellectual abilities in children. However, the optimal dose of folic acid during pregnancy has remained unclear. This new research, led by Dr. Kimford J. Meador, MD, PhD, a study author from Stanford University, reveals a positive connection between folic acid supplementation during early pregnancy and improved brain health outcomes in children.
The study followed 345 children, including 262 children of women with epilepsy and 83 children of women without epilepsy. The researchers recorded the doses of folic acid that the mothers took during the first 12 weeks of pregnancy and categorized the children into five groups based on the average daily dosage: no folic acid, up to 0.4 milligrams (mg) per day, more than 0.4 to 1.0 mg per day, more than 1.0 to 4.0 mg per day, and more than 4.0 mg per day. For general populations, the recommended dose during pregnancy is 0.4 mg per day, but women with epilepsy may be prescribed higher doses.
Children were tested on their verbal skills using vocabulary tests, where they were asked to describe objects, actions, or concepts presented in pictures. The verbal scores for the general population typically range from 70 to 130, with a mean of 100, where higher scores indicate better abilities. Additionally, parents filled out questionnaires assessing their children’s behavioral skills, including communication, social, and daily living skills, with the behavioral scores also ranging from 70 to 130, with a mean of 100.
After adjusting for factors like the mother’s IQ, epilepsy medications, and pregnancy complications, the results showed that children of mothers who took folic acid had an average verbal score of 108, compared to 96 for children whose mothers did not take folic acid. Similarly, the average behavioral score for children whose mothers took folic acid was 102, compared to 82 for those whose mothers did not take folic acid.
When examining children whose mothers had taken folic acid during pregnancy, the scores were found to be similar across low to high doses of the vitamin. Children of mothers who took lower doses (up to 0.4 mg) had an average verbal score of 110, while those whose mothers took higher doses (more than 4.0 mg) had an average verbal score of 108. Both groups had similar average behavioral scores of 103.
Dr. Meador remarked, “While previous studies have raised concerns about higher doses, these findings are reassuring for pregnant women or those planning to have children. Taking a higher dose of folic acid early in pregnancy may still have a positive impact on the brain health of their child.” He also noted the need for further research to determine the ideal dose of folic acid to maximize benefits while minimizing any potential risks to neurodevelopment and other outcomes.
The study’s limitations include the absence of consideration for other factors that could affect folic acid intake and absorption, such as other vitamins or genetic factors. Nonetheless, the study adds important information about the relationship between folic acid supplementation and childhood cognitive and behavioral development.
This study was supported by the National Institute of Neurological Disorders and Stroke and the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
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