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Effect of folic acid supplementation during pregnancy on cognitive development of the child at 6 years: preliminary results from the FASSTT Offspring Trial

Published online by Cambridge University Press:  24 September 2014

C. McGarel ,
H. McNulty ,
J. J. Strain ,
T. Cassidy ,
M. McLoughlin ,
B. McNulty ,
M. Rollins ,
B. Marshall ,
M. Ward  and
A. M. Molloy
...Show all authors
C. McGarel
Affiliation:
Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, BT52 1SA, Northern Ireland
H. McNulty
Affiliation:
Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, BT52 1SA, Northern Ireland
J. J. Strain
Affiliation:
Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, BT52 1SA, Northern Ireland
T. Cassidy
Affiliation:
Psychology Research Institute, University of Ulster, Coleraine, BT52 1SA, Northern Ireland
M. McLoughlin
Affiliation:
Psychology Research Institute, University of Ulster, Coleraine, BT52 1SA, Northern Ireland
B. McNulty
Affiliation:
Institute of Food and Health, UCD, Belfield, Dublin 4
M. Rollins
Affiliation:
Northern Health and Social Care Trust, Causeway Hospital, Northern Ireland
B. Marshall
Affiliation:
Northern Health and Social Care Trust, Causeway Hospital, Northern Ireland
M. Ward
Affiliation:
Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, BT52 1SA, Northern Ireland
A. M. Molloy
Affiliation:
School of Medicine, Trinity College, Dublin 2
K. Pentieva
Affiliation:
Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, BT52 1SA, Northern Ireland
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Abstract

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The well-known protective effect of folic acid against neural tube defects (NTDs) relates to the period of early pregnancy when closure of the neural tube occurs ( 1 ). The role of maternal folic acid supplementation during the later stages of pregnancy is however less clear and it is unknown whether there are any other long term benefits to the offspring. Several lines of evidence suggest that maternal folate intake and status during pregnancy might affect the neurocognitive development( Reference Villamor, Rifas-Shiman and Gillman 2 ) in the offspring and child behaviour( Reference Roza, van Batenburg-Eddes and Steegers 3 ), however the evidence so far is largely limited to observational and animal studies. The aim of the current study was to investigate the effect of folic acid supplementation during pregnancy on the cognitive development of the child at 6 years.

Mother-child pairs (n 62) were recruited from a previous randomised controlled trial which investigated the effect of Folic Acid Supplementation during the Second and Third Trimesters of pregnancy (FASSTT)( Reference McNulty, Pentieva and Marshall 4 ). Cognitive performance of the child was evaluated by a trained researcher using the ‘Wechsler Preschool and Primary Scale of Intelligence, 3rd Edition’ (WPPSI-III). The WPPSI-III is comprised of 14 tests providing composite scores that represent cognitive functioning in specified domains, as well as providing an overall score that represents general intellectual ability.

Analysis showed that children of mothers who received folic acid supplements during the second and third trimesters of pregnancy scored significantly higher in the ‘word processing’ test of the Verbal Composite Score (Table).

Values are presented as mean scores for the Verbal Composite Score and its component tests. WPPSI-III test scores between placebo and treatment groups were compared using ANCOVA adjusting for maternal age, birth weight, maternal education attainment, maternal smoking and alcohol consumption.

While no previous study has investigated the effect on cognitive development of folic acid supplementation during the later stages of pregnancy, the current results are in general agreement with the findings of observational studies published in this area( Reference Roth, Magnus and Schjølberg 5 ). At present, no government guidelines exist for the use of folic acid supplements during the later stages of pregnancy. This preliminary analysis of an on-going trial suggests that there may be potential benefits of continuing folic acid supplementation during pregnancy beyond its established role in the prevention of NTDs

References

1. MRC (1991) Lancet 338, 131–7.Google Scholar
2. Villamor, E, Rifas-Shiman, SL, Gillman, MW et al. (2012) Paediatr Perinat Epidemiol 26, 328–335.Google Scholar
3. Roza, SJ, van Batenburg-Eddes, T, Steegers, EAP et al. (2010) Br J Nutr 103, 445–452.CrossRefGoogle Scholar
4. McNulty, B, Pentieva, K, Marshall, B et al. (2013) Am J Clin Nutr 98, 92–98.Google Scholar
5. Roth, C, Magnus, P, Schjølberg, S et al. (2011) JAMA 306(14), 1566–1573.Google Scholar