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Meta-Analysis
. 2022 Feb;52(2):522-539.
doi: 10.1007/s10803-021-04951-8. Epub 2021 Mar 20.

Prenatal Folic Acid Supplements and Offspring's Autism Spectrum Disorder: A Meta-analysis and Meta-regression

Xian Liu  1   2 , Mingyang Zou  2 , Caihong Sun  2 , Lijie Wu  3 , Wen-Xiong Chen  4
Affiliations
Meta-Analysis

Prenatal Folic Acid Supplements and Offspring's Autism Spectrum Disorder: A Meta-analysis and Meta-regression

Xian Liu et al. J Autism Dev Disord. 2022 Feb.

Abstract

We systematically reviewed the evidence on the association between maternal folic acid supplementation and the risk of offspring's autism spectrum disorders (ASD). A total of 10 studies with 23 sub-studies (9795 ASD cases) were included. Folic acid supplementation during early pregnancy was associated with a lower risk of offspring's ASD [OR 0.57, 95% CI 0.41-0.78]. The consumption of a daily amount of at least 400 μg folic acid from dietary sources and supplements, was associated with a reduced risk of offspring ASD [OR 0.55, 95% CI 0.36-0.83]. Critical effective maternal folic acid supplementation strategies, such as intake timing and intake dosage, may aid the reduction in the risk of offspring ASD. This meta-analysis provided new insights for the prevention of offspring's ASD.

Keywords: Autism spectrum disorder; Folic acid; Meta-analysis; Meta-regression; Prenatal.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of studies selected for inclusion
Fig. 2
Fig. 2
The forest plot of the association between maternal folic acid supplements exposure during the prenatal period and offspring’s ASD
Fig. 3
Fig. 3
Subgroup analysis for maternal use of folic acid supplements and risk of offspring’s ASD
Fig. 4
Fig. 4
Galbraith plot for heterogeneity
Fig. 5
Fig. 5
Influence analysis
Fig. 6
Fig. 6
a The sensitivity analysis after excluding parital heterogeneous studies. b The sensitivity analysis after excluding all heterogeneous studies
Fig. 7
Fig. 7
The pooled estimate of ORs in the meta-analyses using updated quality effects
Fig. 8
Fig. 8
The pooled estimate of RRs in the meta-analyses using updated quality effects
See this image and copyright information in PMC

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