THE INFLUENCE OF FOLIC ACID SUPPLEMENTATION DURING PREGNANCY ON NEURAL TUBE DEVELOPMENT AND CHILD NEURODEVELOPMENT: AN INTEGRATIVE REVIEW

Abstract

Introduction: Pregnancy is a period of intense transformations in which folic acid supplementation plays a crucial role in fetal development and the prevention of neural tube defects. Objective: To describe the repercussions of the use and absence of folic acid supplementation during pregnancy on neural tube formation and child neurodevelopment. Methods: Integrative review based on searches conducted in the PubMed and BVS databases (Medline and Lilacs) in May 2026. Eighteen scientific articles published within the last 10 years, along with four institutional documents, were selected. Data synthesis was performed qualitatively and interpretatively. Results: Periconceptional folic acid supplementation reduces the occurrence of neural tube defects (NTDs) by approximately 57%. Structural closure occurs by the 28th day post-conception, making prior folate reserves crucial for fetal integrity. Adequate levels are associated with improved verbal IQ and a 43% reduction in the risk of autism spectrum disorder (ASD). A relationship was identified, where both deficiency and excess of unmetabolized folic acid may pose risks to development. Limitations of the evidence include recall bias in retrospective studies, the predominance of animal models in biological analyses, heterogeneity in ASD diagnostic criteria, and the scarcity of long-term longitudinal studies. The 10-year time frame was also a limitation of the review process. Conclusion: Early supplementation is an essential protective measure. As implications, it is suggested that public policies focus on preconception education and evaluate the continuation of supplementation throughout pregnancy in order to optimize the offspring’s full functional and cognitive potential.