Prenatal exposure to high-dose folic acid linked to cancer risk in children of mothers with epilepsy
Excessive-dose folic acid is protecting in opposition to congenital malformations if the mom is at specific danger of getting a baby with congenital malformations. Remedy with antiseizure remedy in being pregnant is related to danger of congenital malformations within the kids and girls with epilepsy are due to this fact usually really helpful a supplementary excessive dose of folic acid (4-5 mg day by day) earlier than and through being pregnant. Nevertheless, some research have raised concern that folic acid can enhance the danger of most cancers not solely within the mom, however within the youngster when uncovered throughout being pregnant.
This Scandinavian register-based cohort examine is part of the SCAN-AED mission which is a big examine containing info from a number of nationwide well being registers throughout the Nordic international locations: Denmark, Finland, Iceland, Norway, and Sweden. The researchers examined girls who redeemed prescriptions for high-dose folic acid three months earlier than being pregnant and till delivery, after which adopted every of their kids from delivery. In whole, this examine included 3 379 171 kids wherein 27 784 had been born to moms with epilepsy together with 5933 moms with epilepsy who stuffed a prescription for top dose folic acid.
– We discovered an elevated danger of childhood most cancers if the kid was born to a mom with epilepsy who stuffed for top dose folic acid earlier than or throughout being pregnant, in comparison with kids born to moms with epilepsy with out such prescription fills. The elevated danger of most cancers didn’t change after contemplating different components that would clarify the danger, resembling concomitant fill for antiseizure remedy. We didn’t discover an elevated most cancers danger amongst kids of moms with out epilepsy who used high-dose folic acid, says lead investigator Håkon Magne Vegrim, MD and PhD pupil on the College of Bergen.
The findings couldn’t be defined by maternal epilepsy or different comorbidities resembling maternal tuberous sclerosis, diabetes mellitus, earlier most cancers analysis or particular antiseizure drugs resembling valproate or carbamazepine. Though these are distinctive and regarding outcomes which have potential to vary medical observe worldwide, it must be interpreted with warning:
– The good thing about folic acid dietary supplements for youngster neurodevelopment in pregnant girls utilizing antiseizure medication has been proven in a number of research , says senior creator, Marte Helene Bjørk, professor of neurology, College of Bergen. Folate is necessary for regular progress and mind improvement of the unborn youngster. Whereas the present examine elevate concern concerning the security of high-dose folic acid supplementation, no danger of most cancers has been present in kids after maternal low dose folic acid (0.4 mg) in being pregnant. Antiseizure drugs can work together with the perform, uptake, and break down of the vitamin and trigger elevated want of folate in girls utilizing these drugs. We have to perceive potential mechanisms behind the hyperlink we discovered to most cancers within the youngster, and it’s prudent to establish the optimum dose to steadiness the dangers and advantages.
Vegrim, H.M., et al. (2022) Most cancers Threat in Kids of Moms With Epilepsy and Excessive-Dose Folic Acid Use Throughout Being pregnant. JAMA Neurology. doi.org/10.1001/jamaneurol.2022.2977.