Is excess folic acid supplementation a risk factor for autism?

Abstract

Background The objective was to assess the association between increasing autism incidence rates and the increasing dose of folic acid in prescription prenatal and pediatric vitamins. Methods We used published autism incidence rates from the Rochester Epidemiological Project in Rochester, MN, for 1976–1997. Additionally, we used the percent of prescription prenatal vitamins containing 1 mg folic acid and the percent of prescription pediatric vitamins with any folic acid from Physicians’ Desk References for roughly the same time period. Results The Pearson product moment correlation coefficient ( r) for the association between the percentage of prescription prenatal vitamins containing 1 mg folic acid and research-identified autism incidence in Olmsted County was 0.87 [95% confidence interval (CI) = 0.19–0.99]. In contrast, there was a weak association between pediatric vitamins containing any folic acid and autism incidence using the same statistical method ( r = 0.62, 95% CI = −0.38–0.95). Conclusions If it is true that too little folic acid results in nervous tissue damage, as is accepted by the scientific community in regard to neural tube defects (NTDs), then it seems plausible that too much folic acid may result in nervous tissue damage associated with autism. Although the correlations described here do not provide proof of causation, these data provide an impetus for further study. Children who develop autism may be receiving a massive dose of folic acid in utero, as well as, after birth. It would be of interest to carry out a case–control study using medical record data to document folic acid intake for pregnant women whose offspring were later diagnosed with autism and controls.