In its latest press release on May 11th, 2016, the Johns Hopkins Bloomberg School of Public Health (JHSPH) warns about the risks of potentially harmful outcomes associated with high folate intake during pregnancy.

The press release states that although the high intake of folate or folic acid is recommended for the proper neurological development of the fetus, its excessive amount in the mother’s blood during pregnancy can increase the risks of autism in the babies. The study also suggests that although folate deficiency in the mothers is bad for the proper development of babies, its excess can also harm them significantly. Therefore, the amount of folic acid in the blood should be maintained at the optimum level to avoid any sort of problems.

These suggestions are based on a research study, whose preliminary data will be presented by JHSPH at the International Meeting for Autism Research (IMFAR) in Baltimore, to be held today, May 13th, 2016.

M Daniele Fallin, PhD, Professor and the Director at Wendy Klag Center for Autism and Developmental Disabilities, JHSPH, said, “Adequate supplementation is protective. That’s still the story with folic acid.” Being one of the senior authors of the aforementioned research study, she further elaborated, “We have long known that a folate deficiency in pregnant mothers is detrimental to her child’s development. But what this tells us is that excessive amounts may also cause harm. We must aim for optimal levels of this important nutrient.”

Findings Of The Research Study

During the study it was found that very high levels of folate were observed in the mother immediately after childbirth. The levels of folate in some women were four times higher than the normal, at which the risk to develop autism spectrum disorder (ASD) in her child is doubled. Similarly, the risk increases threefold with excessive levels of Vitamin B-12. Moreover, if both the levels are in excess simultaneously, there is a 17.6 times higher chance for the development of ASD in the child.

The study was conducted by analyzing the data of 1,391 mother and child pairs from the Boston Birth Cohort. This data was based mostly on the population with lower income with the mothers selected for the study ranging from 1998-2013. These mothers were selected at the time of their delivery, after which a follow-up was conducted several years afterwards.

The mothers’ blood folate and Vitamin B-12 levels were checked at regular intervals as well as 1-3 days after the delivery. It was observed that 1 out of 10 subjects had excessive levels of folate i.e., higher than 59nmol/L. Similarly, it was also observed that almost 6% of the female subjects exhibited excessive levels of Vitamin B-12 in their blood i.e., higher than 600pmol/L.

The recommended levels of Vitamin B-12 during the pregnancy have not yet been provided by the World Health Organization (WHO). However, WHO does provide the range for folate in the blood, 13.5-45.3 nmol/L during the first trimester.

In the study, it was observed that almost all of the mothers selected were taking vitamin supplements during the course of their pregnancy, especially folic acid and Vitamin B-12 supplements.

According the scientists conducting the study, more research is required in this aspect in order to demonstrate what optimum levels of folic acid and Vitamin B-12 are required by a woman to ensure proper development of the child during their pregnancy.

The researchers associate the observed excess levels of both folate and vitamin B-12 in some of the women with high consumption of folate fortified food and folic acid rich supplements. The other reason for excessive folate levels in the blood may involve genetic factors. Some people may absorb the folate from the food and supplements at a relatively faster rate and metabolize it at a comparatively slower rate, which leads to excessive folate levels in the body.

Due to these reasons this study can potentially prove wrong the conventional wisdom associated with the use of multi-vitamins and supplements. Convention states that excessive vitamins are excreted out from the body without causing any damage, which can be true for other vitamins but it may be a false perception with folic acid and Vitamin B-12

Ramkripa Raghavan, MPH, MSc, and a DrPH candidate, in the Department of Population, Family and Reproductive Health, JHSPH, said that the present research could be the case of an excess of a good thing turning bad. Dr Raghavan, who is the lead author of the current research, further states, “We tell women to be sure to get folate early in pregnancy. What we need to figure out now is whether there should be additional recommendations about just what an optimal dose is throughout pregnancy.”

About Folate And Folic Acid

The folate under inspection is also known as Vitamin B-9, which is a water soluble vitamin. It is the natural form of Vitamin B-9 and can be found in the natural food such as green, leafy vegetables, spinach, and beans. Folic acid is the synthetic form of folate and is present in multi-vitamins, fortified food, cereals, bread and supplements.

Both folate and folic acid are essential for proper growth of cells and they also help in neural development of the body. According to CDC, every 1 out of 4 women of child bearing age is suffering from inadequate levels of folate in her body. This deficiency can lead to the abnormal neural development of the fetus during early pregnancies. Additionally, risk for the development of ASD is also increased among babies. To combat this, the mothers are forced to take proper fortified supplements to ensure their bodies absorb the folate properly and reduce folate deficiency

About ASD

ASD is an abnormality associated with neural development that is commonly observed among children of 2-3 years of age and is characterized by unusual behavior, social failure and communication problems. In the US, it is observed that every 1 out of 68 children is a sufferer of ASD. The main reasons for its development are still unclear; however, researchers believe that the contributing factors might be genetic or environment related.