People with small bowel disease are often folate deficient.
It is widely known that taking folic acid in early pregnancy reduces the risk of neural tube defects, such as spina bifida.
The current recommended daily dose is 400µg starting before conception.
Some studies have suggested that folic acid may also help prevent facial clefts, but the question remains unresolved.
Dr Allen Wilcox and colleagues from North Carolina assessed the possible effects of folic acid on facial clefts in Norway, which has one of the highest rates of facial clefts in Europe.
The investigators identified infants born from 1996 to 2000.
The investigative team identified 377 presented with cleft lip, with or without cleft palate, 196 with cleft palate only, and 763 healthy controls.
All mothers were surveyed about their reproductive history, smoking, alcohol, drugs, and other exposures during early pregnancy.
|Folic acid supplementation reduces the risk of cleft lip by 40%|
|British Medical Journal|
The investigators asked the patients to recall their diet during the first 3 months of pregnancy, whether they took folic acid supplements.
The investigative team also asked the patients when and how often they took the supplements.
Women were asked similar questions about multivitamins, and the team then estimated each woman's total folic acid intake.
The investigators then adjusted for smoking and other confounding factors.
The team found that folic acid supplementation of 400µg or more a day reduced the risk of cleft lip with or without cleft palate by 40%.
Independent of supplements, diets rich in fruits, vegetables, and other high folate containing foods reduced the risk by 25%.
The team noted that the lowest risk of cleft lip was among women with folate rich diets, who also took folic acid supplements and multivitamins.
The investigative team observed that folic acid provided no protection against cleft palate alone.
Dr Wilcox's team commented, “Our study alone cannot show that folic acid definitely prevents cleft lip”
“Combined with all the previous evidence, however, there is a suggestion of a real preventive effect.”
“If folic acid is able to prevent a major birth defect in addition to neural tube defects, this benefit should be included among the risks and benefits of fortifying foods with folic acid, a matter of ongoing controversy in many countries.”