Periconceptional Folic Acid Supplementation Decreases Risk of Preterm Birth in Epilepsy

May 27, 2022

Article published by Contemporary Pediatrics

Findings from the prospective Norwegian Mother and Child Cohort Study (MoBA) showed that among women with epilepsy on an antiseizure medication (ASM), periconceptional folic acid supplementation was associated with a lower risk of preterm birth. All told, there was a 3-fold increase in the risk among those who did not undergo supplementation vs those who did.

To evaluate whether folic acid supplementation was associated with primary outcomes such as preterm birth (gestational age <37 weeks at birth), small for gestational age (SGA), and preeclampsia, investigators evaluated 100,105 singleton pregnancies from 1999-2008. In 764 of these pregnancies, the mother had a diagnosis of epilepsy; 316 mothers were exposed to ASM during pregnancy and 358 were not.

“Our study supports the recommendation that ASM-treated women with epilepsy with a potential to become pregnant should use daily folic acid supplement,” Alvestad et al wrote. “The optimal dose of folic acid remains unknown and likely varies between ASMs and between individual women. A broad scope of studies on even larger populations are essential to assess the risks and benefits of folic acid for individual ASMs, also taking genetic variations in folate metabolism into account.”