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Association between maternal folate supplementation during pregnancy and the risk of autism spectrum disorder in the offspring: a Meta analysis
YU Xiao-Fang, LI Mei, ZHENG Yan
Chinese Journal of Contemporary Pediatrics ›› 2017, Vol. 19 ›› Issue (3) : 286-291.
PDF(1400 KB)
PDF(1400 KB)
Association between maternal folate supplementation during pregnancy and the risk of autism spectrum disorder in the offspring: a Meta analysis
Objective To quantitatively and comprehensively investigate the association between maternal folate supplementation during pregnancy and the risk of autism spectrum disorder (ASD) in the offspring. Methods PubMed, Embase, Scopus, Cochrane Library, EBSCO, CNKI, Wanfang Data, VIP Database, and Chinese Biomedical Database were searched to collect the articles on maternal folate supplementation during pregnancy and the risk of ASD in children. Odds ratio (OR) and 95% confidence interval (CI) were used to determine the effect size. Stata 12.0 software was used for the Meta analysis. Publication bias evaluation and sensitivity analysis were also performed. Results A total of 10 articles were included according to the inclusion and exclusion criteria, including 15 studies which involved 4 459 cases and 1 225 835 controls. The Meta analysis showed that maternal folate supplementation during pregnancy significantly reduced the risk of ASD in the offspring in the total population (OR=0.798, 95%CI:0.669-0.952, P=0.012). The subgroup analysis revealed that maternal folate supplementation during pregnancy was associated with a reduced risk of ASD in the offspring in both the Asian population (OR=0.664, 95%CI:0.428-1.032, P=0.069) and the Western population (OR=0.817, 95%CI:0.671-0.996, P=0.045). Conclusions Maternal folate supplementation during pregnancy may reduce the risk of ASD in the offspring, especially in the Western population.
Folate / Autism spectrum disorder / Pregnancy / Meta analysis / Child
[1] Ornoy A, Weinstein-Fudim L, Ergaz Z. Prenatal factors associated with autism spectrum disorder (ASD)[J]. Reprod Toxicol, 2015, 56:155-169.
[2] 李侠, 凌子羽, 王建敏, 等. 儿童孤独症围孕期危险因素的1:1配对病例对照研究[J]. 华中科技大学学报(医学版), 2015, 44(3):357-361.
[3] Sun X, Allison C, Matthews FE, et al. Prevalence of autism in mainland China, Hong Kong and Taiwan:a systematic review and meta-analysis[J]. Mol Autism, 2013, 4(1):7.
[4] Ornoy A, Weinstein-Fudim L, Ergaz Z. Genetic syndromes, maternal diseases and antenatal factors associated with autism spectrum disorders (ASD)[J]. Front Neurosci, 2016, 10:316.
[5] Neggers Y. The relationship between folic acid and risk of autism spectrum disorders[J]. Healthcare (Basel), 2014, 2(4):429-444.
[6] Suren P, Roth C, Bresnahan M, et al. Association between maternal use of folic acid supplements and risk of autism spectrum disorders in children[J]. JAMA, 2013, 309(6):570-577.
[7] 蒋辉, 刘俐, 孙灯利, 等. 母亲孕期被动吸烟和补充叶酸与其子女孤独症行为的交互作用[J]. 中华流行病学杂志, 2016, 37(7):940-944.
[8] Virk J, Liew Z, Olsen J, et al. Preconceptional and prenatal supplementary folic acid and multivitamin intake and autism spectrum disorders[J]. Autism, 2016, 20(6):710-718.
[9] Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses[J]. BMJ, 2003, 327(7414):557-560.
[10] Dersimonian R, Laird N. Meta-analysis in clinical trials[J]. Control Clin Trials, 1986, 7(3):177-188.
[11] Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis[J]. Stat Med, 2002, 21(11):1539-1558.
[12] Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias[J]. Biometrics, 1994, 50(4):1088-1101.
[13] Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test[J]. BMJ, 1997, 315(7109):629-634.
[14] Steenweg-de Graaff J, Ghassabian A, Jaddoe VW, et al. Folate concentrations during pregnancy and autistic traits in the offspring. The Generation R Study[J]. Eur J Public Health, 2015, 25(3):431-433.
[15] Al-Farsi YM, Waly MI, Deth RC, et al. Low folate and vitamin B12 nourishment is common in Omani children with newly diagnosed autism[J]. Nutrition, 2013, 29(3):537-541.
[16] Schmidt RJ, Tancredi DJ, Ozonoff S, et al. Maternal periconceptional folic acid intake and risk of autism spectrum disorders and developmental delay in the CHARGE (Childhood Autism Risks from Genetics and Environment) case-control study[J]. Am J Clin Nutr, 2012, 96(1):80-89.
[17] Nilsen RM, Suren P, Gunnes N, et al. Analysis of self-selection bias in a population-based cohort study of autism spectrum disorders[J]. Paediatr Perinat Epidemiol, 2013, 27(6):553-563.
[18] 孙艳丽, 邵婷, 姚余有, 等. 母亲妊娠特有焦虑与学龄前儿童孤独症样行为关系的出生队列研究[J]. 中华预防医学杂志, 2016, 50(2):118-122.
[19] 陈强, 黄丽霞, 徐文娟, 等. 珠海市1.5~3岁孤独症谱系障碍患病率及危险因素研究[J]. 中国儿童保健杂志, 2014, 22(6):649-651.
[20] 康德英, 洪旗, 刘关键, 等. Meta分析中发表性偏倚的识别与处理[J]. 中国循证医学杂志, 2003, 3(1):45-49.
[21] Castro K, Klein Lda S, Baronio D, et al. Folic acid and autism:What do we know?[J]. Nutr Neurosci, 2016, 19(7):310-317.
[22] Devilbiss EA, Gardner RM, Newschaffer CJ, et al. Maternal folate status as a risk factor for autism spectrum disorders:a review of existing evidence[J]. Br J Nutr, 2015, 114(5):663-672.
[23] Vasquez K, Kuizon S, Junaid M, et al. The effect of folic acid on GABA(A)-B 1 receptor subunit[J]. Adv Exp Med Biol, 2013, 775:101-109.
[24] Sun C, Zou M, Zhao D, et al. Efficacy of folic acid supplementation in autistic children participating in structured teaching:an open-label trial[J]. Nutrients, 2016, 8(6):E337.
[25] 李楠楠, 夏薇, 孙彩虹, 等. 叶酸对孤独症儿童的辅助治疗效果研究[J]. 中国儿童保健杂志, 2013, 21(1):13-15.
[26] James SJ, Melnyk S, Fuchs G, et al. Efficacy of methylcobalamin and folinic acid treatment on glutathione redox status in children with autism[J]. Am J Clin Nutr, 2009, 89(1):425-430.
[27] 衣明纪, 王薇, 李音. 生命早期叶酸营养状况与孤独症发病风险[J]. 中国儿童保健杂志, 2014, 22(6):614-616.
[28] Beard CM, Panser LA, Katusic SK. Is excess folic acid supplementation a risk factor for autism?[J]. Med Hypotheses, 2011, 77(1):15-17.
[29] Raghavan R, Fallin MD, Wang XB. Maternal plasma folate, vitamin B12 levels and multivitamin supplementation during pregnancy and risk of autism spectrum disorder in the Boston birth cohort[J]. FASEB J, 2016, 30(1):S151-S156.
[30] Schaevitz LR, Berger-Sweeney JE. Gene-environment interactions and epigenetic pathways in autism:the importance of one-carbon metabolism[J]. ILAR J, 2012, 53(3-4):322-340.
[31] Pu D, Shen Y, Wu J. Association between MTHFR gene polymorphisms and the risk of autism spectrum disorders:a meta-analysis[J]. Autism Res, 2013, 6(5):384-392.
[32] 王馨, 杨文翰, 金宇, 等. 广州市幼儿园儿童孤独症谱系障碍患病率和相关因素[J]. 中国心理卫生杂志, 2011, 25(6):401-408.
