Abstract

To analyze the scientific production regarding maternal folic acid (FA) supplementation and its relationship with autistic spectrum disorder (ASD). We performed unrestricted electronic searches in the BIREME virtual bank, Virtual Health Library (VHL) and Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed) databases. For sample selection, articles that met the proposed objectives were included, published in English, Spanish and Portuguese, the use of Health Sciences Descriptors (DeCS): autistic OR autism AND autism spectrum disorder AND folic acid, AND, with the use of the Medical Subject Headings (MeSH): autistic OR autism AND autistic spectrum disorder AND folic acid. Data extraction was performed by the reviewers with a preestablished data collection formulary. The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) was used based on a checklist with 27 items and a 4-step flowchart. A total of 384 articles was found by the search strategies, of which 17 were eligible following the pre-established criteria. The main findings of the present review point to maternal FA supplementation in the pre-conception period and beginning of pregnancy as a protective effect in relation to ASD, which should be indicated in this period as prevention to the problem. According to the research analyzed, more studies are necessary to know its effects on pregnancy, since the consumption of excessive FA may not be innocuous.

Highlights

  • Autism Spectrum Disorder (ASD) is characterized by persistent deficits in social interaction and communication, with the presence of repetitive interests and activities

  • The main findings of the present review point to maternal folic acid (FA) supplementation in the pre-conception period and beginning of pregnancy as a protective effect in relation to ASD, which should be indicated in this period as prevention to the problem

  • The objective of the present review is to describe the relationship between maternal FA supplementation and ASD, according to scientific publications

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Summary

Introduction

Autism Spectrum Disorder (ASD) is characterized by persistent deficits in social interaction and communication, with the presence of repetitive interests and activities. Since 2004, in Brazil, the Ministry of Health, through the National Health Surveillance Agency (ANVISA, in the Portuguese acronym), adopted the Collegiate Directorate Resolution (RDC, in the Portuguese acronym) No 344 of December 13, 2002, establishing mandatory FA fortification in wheat flour and corn to reduce the prevalence of maternal anemia and defects of the neural tube. This fortification of synthetic FA may have generated a population group with high serum levels of nonmetabolized FA. This finding occurs when > 200mg/day is ingested.[4]

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