Association of the Maternal Folic Acid Supplementation with the Autism Spectrum Disorder: A Systematic Review

Abstract

Objective To analyze the scientific production regarding maternal folic acid (FA) supplementation and its relationship with autistic spectrum disorder (ASD).

Data Sources 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.

Selection of Studies 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 Collection Data extraction was performed by the reviewers with a preestablished data collection formulary.

Data Synthesis 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.

Results 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.

Conclusion 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.

Resumo

Objetivo Analisar a produção científica a respeito da suplementação de ácido fólico (AF) materno e sua relação com o transtorno do espectro autista (TEA).

Fontes de Dados Realizamos buscas eletrônicas irrestritas nas bases de dados do banco virtual BIREME, Biblioteca Virtual em Saúde (VHL) e Medical Literature Analysis and Retrieval System Online (MEDLINE / PubMed).

Seleção dos Estudos Incluímos os artigos publicados em inglês, espanhol e português, com o uso dos DeCS: autistic OR autism AND autism spectrum disorder AND folic acid, e com o uso dos Medical Subject Headings (MeSH, na sigla em inglês): autistic OR autism AND Autistic Spectrum Disorder AND folic acid “.

Coleta de Dados A extração de dados foi realizada pelos revisores com um formulário de coleta de dados pré-estabelecido.

Síntese dos Dados Foram usados os itens de relatório preferidos para protocolos de revisão sistemática e meta-análise (PRISMA-P) com base em uma lista de verificação com 27 itens e um fluxograma de 4 etapas.

Resultados Foram encontrados 384 artigos pelas estratégias de busca, dos quais 17 eram elegíveis segundo os critérios pré-estabelecidos. Os principais achados da presente revisão apontam para a suplementação de AF materno no período de preconcepção e início da gravidez como efeito protetor em relação ao TEA, que deve ser indicada neste período como prevenção do problema.

Conclusão De acordo com as pesquisas analisadas, mais estudos são necessários para conhecer seus efeitos sobre a gravidez, uma vez que o consumo excessivo de AF pode não ser inócuo.

Keywords

autistic spectrum disorder - folic acid - pregnancy - supplementation

Palavras-chave

transtorno do espectro autista - ácido fólico - gravidez - suplementação

Contributors

All the authors participated in the concept and design of the study; in the analysis and interpretation of data; in the draft or revision of the manuscript; and they have approved the manuscript as submitted. All authors are responsible for the reported research.

Publication History

Received: 17 October 2020

Accepted: 07 July 2021

Article published online:
16 November 2021

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