Evidence Rating Level: 2 (Good)
Periconceptional
folic acid (FA) supplementation is a protective factor against neural
tube defects (NTD), with the recommended time period for this
supplementation being limited to the first trimester. This randomized
controlled trial of Folic Acid Supplementation during the Second and
Third Trimesters (FASSTT) conducted from 2006 to 2007 investigated the
potential benefits of FA supplementation during the second and third
trimesters of pregnancy on child neurocognitive performance at seven
years of age. Mothers were randomly assigned to 400μg/d FA or placebo,
starting at 14 weeks’ gestation until pregnancy, with all mothers
receiving FA during the first trimester. Children of the participating
mothers were evaluated at either age three years (n=39) or seven years
(n=70) with the Bayley’s Scale of Infant and Toddler Development
(BSITD-III) or Wechsler Preschool and Primary Scale of Intelligence
(WPPSI-III), respectively, due to test age requirements and normative
data. At seven years, the FA group’s cognitive performance was stronger
than the placebo group in word reasoning (mean scaled score [SS]
difference 1.4, p=0.027). At three years of age, the FA group
outperformed the placebo group in general cognition (mean SS difference
0.8, p=0.040). Compared to a nationally representative sample of British
children aged seven years, WPPSI-III scores in the FA group were higher
in verbal intelligence quotient (IQ; p<0 .001="" and="" beyond="" but="" children="" compared="" continued="" demonstrated="" differences="" during="" fa="" findings="" first="" for="" full="" general="" group="" in="" iq="" language="" may="" national="" neurocognitive="" ntd="" of="" only="" outcomes="" p-0.034="" p="" performance="" placebo="" positive="" prevention="" receive="" sample="" scale="" scores="" second="" significant="" smaller="" study="" suggest="" supplementation="" that="" the="" third="" this="" those="" throughout="" to="" trimester.="" trimesters="" verbal="" who="" wppsi-iii="" yield="">0>
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