Evidence map›Paper›PMID 34440744›Full record

SynthesisCells2021

Folic Acid and Autism: A Systematic Review of the Current State of Knowledge.

Bianka Hoxha, Malvina Hoxha, Elisa Domi, Jacopo Gervasoni, Silvia Persichilli, Visar Malaj, Bruno Zappacosta

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in Cells, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 3 pooled it
4.9field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 3 syntheses or guidelines pooled it, 69 citations in OpenAlex.

  1. Pooled it
  2. Nutritional Status of Children Diagnosed With Autism Spectrum Disorder: A Systematic Review and Meta-Analysis.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2025
    Pooled it
  3. Pooled it
  4. Review
  5. Review
  6. Review
  7. Folate in autism neurodevelopment.Frontiers in nutrition · 2026
    Review
  8. Article
  9. Review
  10. Review
  11. Article
  12. Article
  13. Review
  14. Review
  15. Sex-Based Differences in Prenatal and Perinatal Predictors of Autism Spectrum Disorder Using Machine Learning With National Health Data.Autism research : official journal of the International Society for Autism Research · 2025
    Article
  16. Article
  17. Review
  18. Article
  19. Children (Basel, Switzerland) · 2025
    Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Bianka HoxhaDepartment of Chemical-Pharmaceutical and Biomolecular Technologies, Faculty of Pharmacy, Catholic University "Our Lady of Good Counsel", Rruga Dritan Hoxha, 1000 Tirana, Albania.
Malvina HoxhaDepartment for Chemical-Toxicological and Pharmacological Evaluation of Drugs, Faculty of Pharmacy, Catholic University "Our Lady of Good Counsel", Rruga Dritan Hoxha, 1000 Tirana, Albania.ORCID 0000-0002-1688-116X
Elisa DomiDepartment for Chemical-Toxicological and Pharmacological Evaluation of Drugs, Faculty of Pharmacy, Catholic University "Our Lady of Good Counsel", Rruga Dritan Hoxha, 1000 Tirana, Albania.
Jacopo GervasoniArea Diagnostica di Laboratorio UOC Chimica, Biochimica e Biologia Molecolare Clinica Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy.
Silvia PersichilliArea Diagnostica di Laboratorio UOC Chimica, Biochimica e Biologia Molecolare Clinica Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy.
Visar MalajDepartment of Economics, Faculty of Economy, University of Tirana, 1000 Tirana, Albania.
Bruno ZappacostaDepartment for Chemical-Toxicological and Pharmacological Evaluation of Drugs, Faculty of Pharmacy, Catholic University "Our Lady of Good Counsel", Rruga Dritan Hoxha, 1000 Tirana, Albania.
Catholic University Our Lady of Good Counsel · ALAgostino Gemelli University Polyclinic · ITUniversity of Tirana · AL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Folic acid has been identified to be integral in rapid tissue growth and cell division during fetal development. Different studies indicate folic acid's importance in improving childhood behavioral outcomes and underline its role as a modifiable risk factor for autism spectrum disorders. The aim of this systematic review is to both elucidate the potential role of folic acid in autism spectrum disorders and to investigate the mechanisms involved. Studies have pointed out a potential beneficial effect of prenatal folic acid maternal supplementation (600 µg) on the risk of autism spectrum disorder onset, but opposite results have been reported as well. Folic acid and/or folinic acid supplementation in autism spectrum disorder diagnosed children has led to improvements, both in some neurologic and behavioral symptoms and in the concentration of one-carbon metabolites. Several authors report an increased frequency of serum auto-antibodies against folate receptor alpha (FRAA) in autism spectrum disorder children. Furthermore, methylene tetrahydrofolate reductase (MTHFR) polymorphisms showed a significant influence on ASD risk. More clinical trials, with a clear study design, with larger sample sizes and longer observation periods are necessary to be carried out to better evaluate the potential protective role of folic acid in autism spectrum disorder risk.

Indexed as

Autism Spectrum DisorderAutoantibodiesDietary SupplementsFolate Receptor 1Folic AcidHumansMethylenetetrahydrofolate Reductase (NADPH2)Polymorphism, Single NucleotideRisk FactorsAutoantibodiesFolate Receptor 1Folic AcidMethylenetetrahydrofolate Reductase (NADPH2)autismautism spectrum disordersfolic acidmethylene tetrahydrofolate reductase

Identifiers

PMID34440744
PMCPMC8394938
OpenAlexW3192134007

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.