Evidence map›Paper›PMID 41417222›Full record

ArticleEuropean journal of nutrition2025

A new perspective on the association between maternal folic acid supplementation across the perinatal period and cognitive and behavioral outcomes in children at age 4: findings from the MABC birth cohort study.

Wenjing Qiang, Tuyan Fan, Jingjing Liu, Shuangqin Yan, Guopeng Gao, Xiayan Yu, Hui Gao, Fangbiao Tao, Beibei Zhu

Abstract read
PubMed Publisher
In one paragraph

Article in European journal of nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Folate in autism neurodevelopment.Frontiers in nutrition · 2026
    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

9 authors.

Wenjing QiangDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
Tuyan FanDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
Jingjing LiuDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
Shuangqin YanDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
Guopeng GaoMaternal and Child Health Care Center of Ma'anshan, No 24 Jiashan Road, Ma'anshan, 243011, Anhui, China.
Xiayan YuDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
Hui GaoDepartment of Pediatrics, The First Affiliated Hospital of Anhui Medical University, No.218 Jixi Road, Hefei, 230022, Anhui, China.
Fangbiao Tao *Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. fbtao@ahmu.edu.cn.
Beibei Zhu *Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. 2015500009@ahmu.edu.cn.

Funding

Joint Funds of the National Natural Science Foundation of China Grant No. U22A20361the National Natural Science Foundation of China Grant No. 82073564the Provincial Key Research and Development Project of Anhui Grant No. 202104j07020034
6 · The paper itself

Abstract

purposeThe associations between maternal folic acid (FA) supplementation across the perinatal period and childhood cognitive development and behavioral problems remain unclear. This study aimed to evaluate the relationship between maternal FA supplementation throughout the perinatal period and offspring's cognitive function and behavioral problems at age 4.

methodsBased on the Ma'anshan Birth Cohort Study, pregnant women were recruited at their first antenatal visit from May 2013 to September 2014. Data on maternal FA supplementation before and during pregnancy were collected via questionnaires at up to four time points. At 4 years of age, children's behavioral problems were assessed using the Achenbach Child Behavior Checklist for ages 1.5-5 (CBCL/1.5-5), with two summary scales analyzed. Cognitive development was evaluated using the Chinese version of the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition at 3.0-6.0 years old.

resultsPreconception FA intake was inversely associated with children's cognitive function [visual spatial index (VSI), adjusted regression coefficient (aB) = - 2.05, 95% confidence interval (CI)  - 3.75, - 0.36]. Maternal FA supplementation during the second trimester was significantly associated with an increased risk of externalization problems [adjusted odds ratio (aOR) = 2.89, 95% CI 1.16, 7.19] and lower cognitive function [working memory index (WMI), aB = - 4.81, 95% CI - 8.66, - 0.96]. Furthermore, sex-specific associations were only observed among boys: preconception FA supplementation was negatively associated with cognitive indice (VSI, aB = - 3.71, 95% CI - 6.23, - 1.19); FA supplementation in the second trimester was significantly associated with an increased risk of externalization problems in boys (aOR = 3.39, 95% CI 1.07, 10.74) and lower cognitive function [fluid reasoning index (FRI), aB = - 6.64, 95% CI - 12.44, - 0.85; WMI, aB = - 6.66, 95% CI - 12.56, - 0.77]. No significant associations were observed in girls.

conclusionAmong 4-year-old children, particularly boys, maternal FA supplementation during the second trimester was associated with a higher risk of externalizing behavioral problems, while supplementation in both preconception and second trimester were linked to poorer cognitive development. Well-designed, larger-scale studies are needed to validate these findings.

Indexed as

Child BehaviorCognitionDietary SupplementsFolic AcidMaternal Nutritional Physiological PhenomenaAdultBirth CohortChild DevelopmentChild, PreschoolChinaCohort StudiesFemaleHumansInfantMalePregnancyFolic AcidBehavioral problemsBirth cohort studyCognitive developmentFolic acid supplementation

Identifiers

PMID41417222

What OpenQuestion holds

Textmetadata
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.