A population-based cohort study found that maternal use of multivitamin supplements in early pregnancy was associated with lower risk of autism spectrum disorder (ASD) in offspring .
Previous studies suggest that ASD develops before birth. As maternal nutrition can influence the neurodevelopment of the fetus, researchers speculate that maternal nutrition may influence the risk of ASD in offspring.
An international collaboration led by the Department of Epidemiology and Biostatistics at the Drexel University (Philadelphia, USA) set out to investigate the association between mothers’ use of supplementation during pregnancy and risk of ASD in their offspring who were aged 4 to 15 years.
They analyzed data from the Stockholm Youth Cohort, which included 273,107 mother-child pairs living in Stockholm County (Sweden). Mother’s use of multivitamin, iron, and folic supplementation was reported at the first antenatal visit. Diagnosis of ASD with and without intellectual disability in children was obtained from register data.
The researchers found that the prevalence of offspring ASD with intellectual disability was 0.26% and 0.48% in the maternal multivitamin use group and the non-use group, respectively. This meant that mothers who used multivitamin (with or without additional iron or folic acid, or both) was associated with an average 31% lower risk of ASD in child compared with mothers who did not use supplements. After adjusting for potential confounders and using other analytic methods, similar estimates were found.
However, the association study does not prove that multivitamin use caused lower risk of developing ASD in child. Due to limitations of the data, the study cannot answer how type, timing, and dose of supplement influences the ASD risk. Also, it remains to be determined whether there is a critical window for multivitamin use by mother and whether certain combinations of specific nutrients are responsible for the prevention of ASD.
The study results were published in the journal BMJ (October 2017).
Why is this Clinically Relevant?
- Maternal nutrition during pregnancy is essential for the wellbeing of offspring. This study indicates it is also associated with lower risk of ASD
- Clinicians may recommend multivitamin supplement for women who plan to become pregnant or are in early pregnancy
- It is important to select supplements that are manufactured according to GMP which ensures quality standard
 DeVilbiss, E.A., et al., Antenatal nutritional supplementation and autism spectrum disorders in the Stockholm youth cohort: population based cohort study. BMJ, 2017. 359: p. j4273.