Benefits and Risks of Periconceptional Folic Acid Supplementation

To the Editor Vegrim et al conducted an observational population-based study from 3 northern European countries and concluded that prenatal exposure to high-dose folic acid is associated with a 2.7-fold increased risk of pediatric cancer in children of mothers with epilepsy who were taking antiseizure medications. These findings are based on 18 children with cancer who were born to mothers with epilepsy taking high-dose folic acid (mean dose, 4.3 mg). The study exonerates epilepsy alone as a risk factor, but because of insufficient numbers, the contribution of antiseizure medications remains unclear. Children of mothers without epilepsy taking high-dose folate do not carry the same risk. Thus, a possible interaction of antiseizure medications with folate or other unaccounted confounding factors are probably contributing.
Source: JAMA Neurology - Category: Neurology Source Type: research