A new study presented on March 4, 2025, suggests that higher doses of folic acid during the first trimester of pregnancy are not only safe but also associated with enhanced verbal and behavioral skills in children at age six. The findings will be discussed at the American Academy of Neurology’s 77th Annual Meeting in San Diego, taking place from April 5-9, 2025.
Folic acid supplementation during pregnancy is well-known for its role in reducing birth defects and supporting brain development in children. However, the optimal dosage remains unclear. This latest study provides valuable insights into how folic acid may influence brain health outcomes without apparent risks, even at higher doses.
Kimford J. Meador, MD, PhD, a study author and researcher at Stanford University in Palo Alto, California, emphasized, “Our study provides new information showing a positive connection between taking folic acid during early pregnancy and brain health outcomes in children, with no evidence of negative effects at higher doses.”
The study involved 345 children, including 262 whose mothers had epilepsy and 83 whose mothers did not. Researchers tracked the doses of folic acid taken by the mothers during the first 12 weeks of pregnancy and divided the children into five groups based on their mothers’ folic acid intake: no folic acid, up to 0.4 milligrams (mg) per day, 0.4 to 1.0 mg per day, 1.0 to 4.0 mg per day, and more than 4.0 mg per day. The standard recommended dose for pregnant women is 0.4 mg per day, though women with epilepsy often receive higher prescriptions.
At age six, children were tested for verbal skills, including vocabulary, where participants were asked to describe objects or actions in pictures. The general population’s verbal test scores typically range from 70 to 130, with an average of 100. In addition, parents filled out questionnaires about their children’s behavior, assessing skills like communication, social interaction, and daily living. Behavioral scores also ranged from 70 to 130, with an average score of 100.
The results showed that after adjusting for factors such as the mother’s IQ, epilepsy medications, and pregnancy complications, children whose mothers took folic acid had an average verbal score of 108, compared to 96 in children whose mothers did not take folic acid. The behavioral scores were similarly higher for children whose mothers used folic acid, with an average score of 102 compared to 82 in the non-supplemented group.
Interestingly, among children whose mothers took folic acid, the verbal and behavioral scores were similar across all dosage groups, from low to high doses. For example, children of mothers who took a low dose of folic acid had an average verbal score of 110, while those whose mothers took a high dose scored 108. Behavioral scores were consistent across the groups, with both low and high-dose children averaging 103.
Dr. Meador reassured that while previous studies had raised concerns about potential risks with high folic acid doses, the current study offers reassurance that higher doses during pregnancy do not negatively impact brain development. However, he emphasized the need for further research to determine the most effective dose that maximizes benefits and minimizes risks for various groups of women.
The study did not account for other factors that might influence folic acid absorption, such as additional vitamins or genetic factors, which remains a limitation.
The research was funded by the National Institute of Neurological Disorders and Stroke and the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
Related topic:
Maternal Stress and Its Impact on Gut and Breastmilk Microbiota
Obesity in Children Linked to Increased Skin Conditions
Medicaid Extension Cuts Postpartum Uninsurance, But Gaps Remain
