Study · PloS one · 2017Conflicts declared

Folic acid before pregnancy and heart defects in babies

What it found

In a group of women in China, those who took folic acid supplements before pregnancy were less likely to have a baby with a congenital heart defect.

Lower dietary folate during pregnancy was linked to a higher risk.

What they found

Studies in people

Folic acid before pregnancy

Women who took folic acid supplements before pregnancy had a lower risk of having a baby with a congenital heart defect compared with women who did not take them. The link was stronger the longer they took the supplements.

Folic acid during pregnancy

Taking folic acid supplements during pregnancy was not clearly linked to the risk of congenital heart defects.

Low dietary folate

Women with the lowest dietary folate intake during pregnancy (less than 149.88 micrograms per day) had a higher risk of a baby with a congenital heart defect, and a higher risk of patent ductus arteriosus specifically.

Types of heart defect

The lower risk with folic acid before pregnancy was seen for malformations of the great arteries, malformations of the cardiac septa, atrial septal defect, and for babies with more than one heart defect. No clear link was seen for isolated heart defects.

Folate from food and supplements

Women who did not take folic acid supplements and also had low dietary folate had almost twice the risk of having a baby with a congenital heart defect.

What the authors conclude

“Our study suggested that folic acid supplementation before pregnancy was associated with a reduced risk of CHDs, lower dietary folate intake during pregnancy was associated with increased risk.”
Mao B, Qiu J, Zhao N, et al, 2017

Also in their conclusions

  • They conclude that folic acid supplementation before pregnancy was associated with a reduced risk of congenital heart defects, and that lower dietary folate intake during pregnancy was associated with increased risk.
  • They say the associations varied by subtype of congenital heart defect.
  • They call for larger studies to clarify the links by subtype and to identify women who would benefit most from folic acid supplements.

How it was done

Earlier studies on whether folic acid before or during pregnancy lowers the risk of congenital heart defects had given mixed results. The authors wanted to look at folic acid supplements and dietary folate together.

They followed 10,087 women who gave birth at one hospital in Lanzhou, China, between 2010 and 2012. They asked about folic acid supplements and diet, and recorded which babies were born with congenital heart defects.

What it can’t tell you

  • This was a study that followed women over time, so it can show links but cannot prove that folic acid directly causes the difference in heart defect risk.
  • The number of babies with heart defects was small, which limits how precisely the risks for each subtype could be measured.
  • Diet and supplement use were asked about after delivery, so women may not have remembered them exactly.

The paper

Title
Maternal folic acid supplementation and dietary folate intake and congenital heart defects
Type
Study
Evidence
Studies in people
Summarised from
Full text
Cite
Mao B, Qiu J, Zhao N, et al (2017). Maternal folic acid supplementation and dietary folate intake and congenital heart defects. PloS one. doi:10.1371/journal.pone.0187996Free full textPubMed 29145433DOI

Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error