ArticleBMC medicine2023
Initiation and duration of folic acid supplementation in preventing congenital malformations.
Article in BMC medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Folic acid supplementation during preconception period in sub-Saharan African countries: A systematic review and meta-analysis.PloS one · 2025Pooled it
- The effect of folic acid intake on congenital anomalies. A systematic review and meta-analysis.Frontiers in pediatrics · 2024Pooled it
- High prevalence of congenital heart disease among hospitalized neonates in northwestern Tanzania; implications of maternal and environmental factors.International journal of cardiology. Congenital heart disease · 2026Article
- Folic acid supplementation and prevention of adverse offspring outcomes among women with epilepsy: An observational study.Epilepsia · 2026Observational
- Nutrition, Physical Activity and Other Health Aspects Before and During Pregnancy - Recommendations by the Nationwide "Healthy Start Network" (Netzwerk Gesund ins Leben) 2026.Geburtshilfe und Frauenheilkunde · 2026Article
- Care of Patients After Bariatric Surgery in the Periconceptional and Perinatal Periods.Nutrients · 2026Review
- The First 1000 Days of PKU: A Narrative Review of Maternal PKU and Early Life Management After Positive Newborn Screening.Nutrients · 2026Review
- Maternal red blood cell folate metabolites were dynamically associated with neonatal amino acids and acylcarnitines in heel blood: a prospective cohort study.Nutrition & metabolism · 2026Article
- Association of combined folic acid and progesterone use with congenital malformations in women with vaginal bleeding during early pregnancy: a multicenter cohort study.European journal of medical research · 2025Article
- Epilepsy in women of childbearing age: a focused review.Neurological research and practice · 2025Review
- Head circumference as an early predictor of fetal death in fetuses with increased nuchal translucency: evidence from a multicenter cohort study.European journal of medical research · 2025Article
- Scientific and Public Health Challenges in Folic Acid Supplementation: Insights from Brazil and Global Implications.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
- Maternal red blood cell folate and vitamin B metabolism with pregnancy outcomes: a retrospective study.BMC pregnancy and childbirth · 2025Article
- Preconceptional and Periconceptional Folic Acid Supplementation in the Visegrad Group Countries for the Prevention of Neural Tube Defects.Nutrients · 2024Review
- Maternal multivitamin supplementation mitigates the risk of fetal congenital heart disease associated with high indoor total volatile organic compounds exposure in east china: a case-control study.Environmental health : a global access science source · 2024Article
- Evaluating Access to Health Care in Mothers and Caregivers of Children under Five Years of Age in Rural Communities of Yucatán, Mexico.International journal of environmental research and public health · 2024Article
- Nutraceuticals in Pregnancy: A Special Focus on Probiotics.International journal of molecular sciences · 2024Review
- Folic Acid and Selected Risk Factors for Fetal Heart Defects-Preliminary Study Results.Nutrients · 2024Article
- Maternal influences on offspring food allergy.Immunological reviews · 2024Review
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFolic acid (FA) supplementation is associated with a lower risk of the neural tube and heart defects and is recommended for women of childbearing age. Although there are detailed recommendations, differences in the initiation time and duration of FA supplementation remain poorly studied.
methodsA multicentre prospective study of 17,713 women was conducted. The incidence of congenital malformations in women taking a recommended dosage (e.g. 0.4 or 0.8 mg/day) of FA was compared with that in women without supplementation. The predicted probability of malformations by the initiation time and duration of FA use was estimated to determine optimal options.
resultsPericonceptional FA supplementation was associated with a lower and insignificant risk of congenital malformations (1.59% vs. 2.37%; odds ratio [OR] 0.69; 95% confidence interval [CI]: 0.44-1.08), heart defects (3.8 vs. 8.0 per 1000 infants; OR, 0.47; 0.21-1.02), and neural tube defects (7.0 vs. 11.5 per 10,000 infants; OR, 0.64; 0.08-5.15). FA use after pregnancy provided greater protection against total malformations. Statistically significant associations were found in women who initiated FA supplementation in the first month of gestation (OR, 0.55; 95% CI: 0.33-0.91) and in those who supplemented for 1 to 2 months (OR, 0.59; 95% CI: 0.36-0.98). Similar results were found for heart defects. The optimal initiation time was 1.5 (optimal range: 1.1 to 1.9) months before pregnancy and a duration of 4.0 (3.7 to 4.4) months was reasonable to achieve the lowest risk of congenital malformations. Heart defect prevention required an earlier initiation (2.2 vs. 1.1 months before pregnancy) and a longer duration (4.7 vs. 3.7 months) than the prevention of other malformations.
conclusionsThe timely initiation of FA supplementation for gestation was associated with a decreased risk of congenital malformations, which was mainly attributed to its protection against heart defects. The initiation of FA supplementation 1.5 months before conception with a duration of 4 months is the preferred option for congenital malformation prevention.
trial registrationChictr.org.cn identifier: ChiCTR-SOC-17010976.
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