J Prev Med Public Health.  2019 Jul;52(4):205-213. 10.3961/jpmph.19.020.

The Protective Effect of Maternal Folic Acid Supplementation on Childhood Cancer: A Systematic Review and Meta-analysis of Case-control Studies

• Wan Ismail WR
• Abdul Rahman R
• Rahman NA
• Atil A
• Nawi AM

• KMID: 2455124
• DOI: http://doi.org/10.3961/jpmph.19.020

Abstract

OBJECTIVES
Maternal folic acid supplementation is considered mandatory in almost every country in the world to prevent congenital malformations. However, little is known about the association of maternal folic acid intake with the occurrence of childhood cancer. Hence, this study aimed to determine the effects of maternal folic acid consumption on the risk of childhood cancer.
METHODS
A total of 158 related articles were obtained from PubMed, Google Scholar, Scopus, and ProQuest using standardized keywords, of which 17 were included in the final review.
RESULTS
Eleven of the 17 articles showed a significant protective association between maternal folic acid supplementation and childhood cancer. Using a random-effects model, pooled odds ratios (ORs) showed a protective association between maternal folic acid supplementation and childhood acute lymphoblastic leukaemia (OR, 0.75; 95% confidence interval [CI], 0.66 to 0.86). However, there was no significant association between maternal folic acid supplementation and acute myeloid leukaemia (OR, 0.70; 95% CI, 0.46 to 1.06) or childhood brain tumours (OR, 1.02; 95% CI, 0.88 to 1.19).
CONCLUSIONS
Maternal folic acid supplementation was found to have a protective effect against childhood acute lymphoblastic leukaemia. Thus, healthcare professionals are recommended to provide regular health education and health promotion to the community on the benefits of folic acid supplementation during pregnancy.

Keyword

Childhood cancer; Maternal; Folate; Vitamin supplementation

MeSH Terms

Brain
Case-Control Studies*
Delivery of Health Care
Folic Acid*
Health Education
Health Promotion
Odds Ratio
Pregnancy
Folic Acid