title: Folic acid supplements in pregnancy and severe language delay in children.
abstract: BACKGROUND
  Prenatal folic acid supplements reduce the risk of neural tube defects and may have beneficial effects on other aspects of neurodevelopment.
  
  
  OBJECTIVE
  To examine associations between mothers' use of prenatal folic acid supplements and risk of severe language delay in their children at age 3 years.
  
  
  METHODS
  The prospective observational Norwegian Mother and Child Cohort Study recruited pregnant women between 1999 and December 2008. Data on children born before 2008 whose mothers returned the 3-year follow-up questionnaire by June 16, 2010, were used. Maternal use of folic acid supplements within the interval from 4 weeks before to 8 weeks after conception was the exposure. Relative risks were approximated by estimating odds ratios (ORs) with 95% CIs in a logistic regression analysis.
  
  
  METHODS
  Children's language competency at age 3 years measured by maternal report on a 6-point ordinal language grammar scale. Children with minimal expressive language (only 1-word or unintelligible utterances) were rated as having severe language delay.
  
  
  RESULTS
  Among 38,954 children, 204 (0.5%) had severe language delay. Children whose mothers took no dietary supplements in the specified exposure interval were the reference group (n = 9052 [24.0%], with severe language delay in 81 children [0.9%]). Adjusted ORs for 3 patterns of exposure to maternal dietary supplements were (1) other supplements, but no folic acid (n = 2480 [6.6%], with severe language delay in 22 children [0.9%]; OR, 1.04; 95% CI, 0.62-1.74); (2) folic acid only (n = 7127 [18.9%], with severe language delay in 28 children [0.4%]; OR, 0.55; 95% CI, 0.35-0.86); and (3) folic acid in combination with other supplements (n = 19,005 [50.5%], with severe language delay in 73 children [0.4%]; OR, 0.55; 95% CI, 0.39-0.78).
  
  
  CONCLUSIONS
  Among this Norwegian cohort of mothers and children, maternal use of folic acid supplements in early pregnancy was associated with a reduced risk of severe language delay in children at age 3 years.
authors: Division of Mental Health, Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403 Oslo, Norway. christine.roth@fhi.no
authors: Christine
authors: C
authors: Roth
authors: Per
authors: P
authors: Magnus
authors: Synnve
authors: S
authors: Schjølberg
authors: Camilla
authors: C
authors: Stoltenberg
authors: Pål
authors: P
authors: Surén
authors: Ian W
authors: IW
authors: McKeague
authors: George
authors: G
authors: Davey Smith
authors: Ted
authors: T
authors: Reichborn-Kjennerud
authors: Ezra
authors: E
authors: Susser
mesh_terms: D000328:Adult; D002675:Child, Preschool; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007805:Language Development Disorders / Q000145:classification / Q000517:prevention & control*; D009436:Neural Tube Defects / Q000517:prevention & control; D009664:Norway / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D011295:Prenatal Care; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies; D012044:Regression Analysis; D012306:Risk; D014803:Vitamin B Complex / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D014803:Vitamin B Complex; D005492:Folic Acid