ReviewPreventive medicine reports2021
Maternal folic acid and multivitamin supplementation: International clinical evidence with considerations for the prevention of folate-sensitive birth defects.
Review in Preventive medicine reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 52 citations in OpenAlex.
- FIGO good practice recommendations on anemia in pregnancy, to reduce the incidence and impact of postpartum hemorrhage (PPH).International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Guideline
- Vitamin B12 and Folate Status in Pregnant Females and Their Infants in Norway: Secondary Analysis from the Mommy's Food Study.The Journal of nutrition · 2023Trial
- Role of hormone testing in assessment of infertility.Canadian family physician Medecin de famille canadien · 2026Article
- Choline and Its Companions: Inter-Related Roles of Choline and B Vitamins in Fetal Development and Offspring Health.Nutrients · 2026Review
- High folic acid supplementation is associated with vaginal bleeding in early pregnancy in a fetal sex-specific manner: findings from two prospective cohort studies.Reproductive health · 2026Article
- Sex and gender-related differences in neurological diseases: current challenges and recommendations for clinical practice.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Review
- Excess folic acid disrupts placental endocrine functionFrontiers in nutrition · 2026Article
- Effects of maternal arginine supplementation during lactation on offspring growth and wound healing in an experimental rat model of intrauterine malnutrition.Acta cirurgica brasileira · 2026Article
- Beyond Calories: Addressing Micronutrient Deficiencies in the World's Most Vulnerable Communities-A Review.Nutrients · 2025Review
- Uncovering the hidden hunger in translational research for periconceptional folic acid awareness among health care providers.Journal of family medicine and primary care · 2025Article
- Article
- Biological, dietetic and pharmacological properties of vitamin BNPJ science of food · 2025Review
- Prenatal Diagnosis of Reno-Urinary Malformations in a Tertiary Center of Republic of Moldavia.Diagnostics (Basel, Switzerland) · 2024Article
- Article
- Evaluation of Urinary L-FABP as a Tubular Damage Marker in Pediatric Neurogenic Bladder-A Pilot Study.Journal of clinical medicine · 2024Article
- Maternal Smoking during Pregnancy and its effects on Neural Tube Defects.Iranian journal of child neurology · 2024Article
- A critical evaluation of prenatal supplements: Are they meeting the mark?Journal of family medicine and primary care · 2023Review
- Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review.Nutrients · 2023Review
- Before Is Better: Innovative Multidisciplinary Preconception Care in Different Clinical Contexts.Journal of clinical medicine · 2023Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
More evidence is available for maternal intake, absorption, distribution, tissue specific concentrations, and pregnancy outcomes with folic acid (fortification/supplementation) during preconception - first trimester. This Quality Improvement prevention review used expert guidelines/opinions, systematic reviews, randomized control trials/controlled clinical trials, and observational case control/case series studies, published in English, from 1990 to August 2021. Optimization for an oral maternal folic acid supplementation is difficult because it relies on folic acid dose, type of folate supplement, bio-availability of the folate from foods, timing of supplementation initiation, maternal metabolism/genetic factors, and many other factors. There is continued use of high dose pre-food fortification 'RCT evidenced-based' folic acid supplementation for NTD recurrence pregnancy prevention. Innovation requires preconception and pregnancy use of 'carbon one nutrient' supplements (folic acid, vitamin B12, B6, choline), using the appropriate evidence, need to be considered. The consideration and adoption of directed personalized approaches for maternal complex risk could use serum folate testing for supplementation dosing choice. Routine daily folic acid dosing for low-risk women should consider a multivitamin with 0.4 mg of folic acid starting 3 months prior to conception until completion of breastfeeding. Routine folic acid dosing or preconception measurement of maternal serum folate (after 4-6 weeks of folate supplementation) could be considered for maternal complex risk group with genetic/medical/surgical co-morbidities. These new approaches for folic acid oral supplementation are required to optimize benefit (decreasing folate sensitive congenital anomalies; childhood morbidity) and minimizing potential maternal and childhood risk.
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