BACKGROUND Periconceptional folic acid prevents neural tube defects (NTDs), but it is uncertain whether there are benefits for offspring neurodevelopment arising from continued maternal folic acid supplementation beyond the first trimester. We investigated the effect of folic acid supplementation during trimesters 2 and 3 of pregnancy on cognitive performance in the child. METHODS We followed up the children of mothers who had participated in a randomized controlled trial in 2006/2007 of Folic Acid Supplementation during the Second and Third Trimesters (FASSTT) and received 400 μg/d folic acid or placebo from the 14th gestational week until the end of pregnancy. Cognitive performance of children at 7 years was evaluated using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III) and at 3 years using the Bayley's Scale of Infant and Toddler Development (BSITD-III). RESULTS From a total of 119 potential mother-child pairs, 70 children completed the assessment at age 7 years, and 39 at age 3 years. At 7 years, the children of folic acid treated mothers scored significantly higher than the placebo group in word reasoning: mean 13.3 (95% CI 12.4-14.2) versus 11.9 (95% CI 11.0-12.8); p = 0.027; at 3 years, they scored significantly higher in cognition: 10.3 (95% CI 9.3-11.3) versus 9.5 (95% CI 8.8-10.2); p = 0.040. At both time points, greater proportions of children from folic acid treated mothers compared with placebo had cognitive scores above the median values of 10 (girls and boys) for the BSITD-III, and 24.5 (girls) and 21.5 (boys) for the WPPSI-III tests. When compared with a nationally representative sample of British children at 7 years, WPPSI-III test scores were higher in children from folic acid treated mothers for verbal IQ (p < 0.001), performance IQ (p = 0.035), general language (p = 0.002), and full scale IQ (p = 0.001), whereas comparison of the placebo group with British children showed smaller differences in scores for verbal IQ (p = 0.034) and full scale IQ (p = 0.017) and no differences for performance IQ or general language. CONCLUSIONS Continued folic acid supplementation in pregnancy beyond the early period recommended to prevent NTD may have beneficial effects on child cognitive development. Further randomized trials in pregnancy with follow-up in childhood are warranted. TRIAL REGISTRATION ISRCTN ISRCTN19917787 . Registered 15 May 2013.

中文翻译：

---

妊娠中期以后继续补充叶酸对儿童认知能力的影响：一项来自随机对照试验（FASSTT后代试验）的随访研究。

背景技术孕周叶酸可预防神经管缺陷（NTDs），但尚不确定孕中期以后孕妇继续补充叶酸对后代神经发育是否有益处。我们调查了妊娠中期2和3期间补充叶酸对儿童认知能力的影响。方法我们对2006/2007年中期和中期参加叶酸补充剂（FASSTT）随机对照试验的母亲的孩子进行了随访，从妊娠第14周到妊娠期间接受了400μg/ d的叶酸或安慰剂。怀孕结束。使用Wechsler学龄前和小学智力量表（WPPSI-III）评估了7岁儿童的认知能力，使用Bayley's评估了3岁儿童的认知能力。婴幼儿发展量表（BSITD-III）。结果在总共119对潜在的母子对中，有70名儿童在7岁时完成了评估，而39名儿童在3岁时完成了评估。7岁时，经叶酸治疗的母亲的孩子在单词推理方面得分明显高于安慰剂组：平均13.3（95％CI 12.4-14.2）对11.9（95％CI 11.0-12.8）；p = 0.027；在3年时，他们的认知得分明显更高：10.3（95％CI 9.3-11.3）对9.5（95％CI 8.8-10.2）；p ＝ 0.040。在两个时间点，叶酸治疗母亲的孩子比例均高于安慰剂，其中BSITD-III的认知得分高于10（女孩和男孩），WPPSI的中位数高于24.5（女孩）和21.5（男孩）。 -III测试。与全国有代表性的7岁英国儿童进行比较时，叶酸治疗母亲的儿童的口头智商（p <0.001），表现智商（p = 0.035），通用语言（p = 0.002）和全面智商（p = 0.001）的WPPSI-III测试得分更高。安慰剂组与英国儿童的比较显示，言语智商（p = 0.034）和全面智商（p = 0.017）的得分差异较小，而表现智商或普通语言的得分差异也较小。结论建议在妊娠早期继续补充叶酸以预防NTD可能对儿童认知发育有有益作用。有必要在妊娠期进行进一步的随机试验，并在儿童期进行随访。ISRCTN ISRCTN19917787试注册。2013年5月15日注册。一般语言（p = 0.002）和全面智商（p = 0.001），而安慰剂组与英国儿童的比较显示，语言智商（p = 0.034）和全面智商（p = 0.017）的得分差异较小，表现智商或通用语言没有差异。结论建议在妊娠早期继续补充叶酸以预防NTD可能对儿童认知发育有有益作用。有必要在妊娠期进行进一步的随机试验，并在儿童期进行随访。ISRCTN ISRCTN19917787试注册。2013年5月15日注册。一般语言（p = 0.002）和全面智商（p = 0.001），而安慰剂组与英国儿童的比较显示，语言智商（p = 0.034）和全面智商（p = 0.017）的得分差异较小，表现智商或通用语言没有差异。结论建议在妊娠早期继续补充叶酸以预防NTD可能对儿童认知发育有有益作用。有必要在妊娠期进行进一步的随机试验，并在儿童期进行随访。ISRCTN ISRCTN19917787试注册。2013年5月15日注册。017），并且在性能智商或通用语言方面没有差异。结论建议在妊娠早期继续补充叶酸以预防NTD可能对儿童认知发育有有益作用。有必要在妊娠期进行进一步的随机试验，并在儿童期进行随访。ISRCTN ISRCTN19917787试注册。2013年5月15日注册。017），并且在性能智商或通用语言方面没有差异。结论建议在妊娠早期继续补充叶酸以预防NTD可能对儿童认知发育有有益作用。有必要在妊娠期进行进一步的随机试验，并在儿童期进行随访。ISRCTN ISRCTN19917787试注册。2013年5月15日注册。