Prenatal Folic Acid Decreases Speech Delay

I know it seems as if I'm anti-dietary supplements but nothing could be further from the truth.  What I want is truth in advertising w/responsible manufacturing & marketing, where both pharmaceutical & supplement companies have to prove safety & efficacy. But I digress.

In the same issue of JAMA that carried the Iowa Women's Health Study linking multivitamins & dietary supplements to an increase in mortality in post-menopausal women, another was quietly published associating prenatal folic acid w/lower risk of severe language delay at 3yo.

In this particular study, the authors analyzed 38,954 children born to Norwegian women who had completed a questionnaire regarding use & timing of folic acid.  Specifically, they concluded that consumption of folic acid supplements from 4 weeks prior to 8 weeks after conception was associated w/significantly lower risk of severe language delay at 3yo.  

The importance of this study is the timing of folic acid, especially starting 4 weeks prior to conception and continuing on for at least another 8 weeks after conception.  In other words, in addition to being important in spinal cord development (minimizing risk of neurotube defects), it appears that folic acid is also necessary for language skills development.

The implication for family physicians is to even more strongly counsel our patients to start taking folic acid as soon as they stop using contraception because by the time someone realizes that she is pregnant, she'll be 8 weeks into that extremely important 3 month period of supplementation.  That's why preconception counseling is so important.  Just another example of the counseling & coordination of care that family physicians provide!

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