The Effect of Folic Acid Supplementation During Pregnancy on Infant Brain Health and Development: A Study in Cirebon District, Indonesia
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Published:
Apr 23, 2025
Keywords:
folic acid supplementation, pregnancy, infant brain health, neural tube defects, cognitive development
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Abstract
This study investigates the effect of folic acid supplementation during pregnancy on infant brain health and development in Cirebon District, Indonesia. Folic acid is essential for preventing neural tube defects (NTDs) and supporting fetal brain development, yet adherence to supplementation guidelines remains variable, particularly in rural and underserved areas. The research aimed to evaluate the impact of folic acid intake on the incidence of NTDs, cognitive development, and neurodevelopmental disorders, such as autism and ADHD, in infants born to mothers who followed recommended supplementation practices. The study employed a cross-sectional design, analyzing the health outcomes of 300 infants born between 2022 and 2023. Data were collected through interviews with pregnant women, medical records, and assessments of infant development. Results indicate a significant reduction in NTDs and improved cognitive function, motor skills, and developmental milestones in infants whose mothers adhered to folic acid supplementation guidelines. Additionally, the study highlights the importance of addressing cultural, socioeconomic, and access barriers to ensure effective supplementation practices. These findings contribute to the growing body of evidence supporting folic acid supplementation as a key strategy for enhancing prenatal and infant health. The research calls for stronger public health policies to improve the accessibility and adherence to folic acid supplementation programs, particularly in rural regions, to ensure optimal fetal brain development and long-term health benefits for infants.
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How to Cite
Qadriya, F., & Safira, M. (2025). The Effect of Folic Acid Supplementation During Pregnancy on Infant Brain Health and Development: A Study in Cirebon District, Indonesia. International Journal on Health and Medical Sciences, 3(2), 68–76. https://doi.org/10.35335/healmed.v3i2.427
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Richards, E., Theobald, S., George, A., Kim, J. C., Rudert, C., Jehan, K., & Tolhurst, R. (2013). Going beyond the surface: gendered intra-household bargaining as a social determinant of child health and nutrition in low and middle income countries. Social Science & Medicine, 95, 24–33.
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van Gool, J. D., Hirche, H., Lax, H., & De Schaepdrijver, L. (2018). Folic acid and primary prevention of neural tube defects: A review. Reproductive Toxicology, 80, 73–84.
van Wijngaarden, J. P., Dhonukshe-Rutten, R. A. M., van Schoor, N. M., van der Velde, N., Swart, K. M. A., Enneman, A. W., van Dijk, S. C., Brouwer-Brolsma, E. M., Zillikens, M. C., & van Meurs, J. B. J. (2011). Rationale and design of the B-PROOF study, a randomized controlled trial on the effect of supplemental intake of vitamin B 12 and folic acid on fracture incidence. BMC Geriatrics, 11, 1–11.
Bailey, R. L., West Jr, K. P., & Black, R. E. (2015). The epidemiology of global micronutrient deficiencies. Annals of Nutrition and Metabolism, 66(Suppl. 2), 22–33.
Barros, A. J. D., Ronsmans, C., Axelson, H., Loaiza, E., Bertoldi, A. D., França, G. V. A., Bryce, J., Boerma, J. T., & Victora, C. G. (2012). Equity in maternal, newborn, and child health interventions in Countdown to 2015: a retrospective review of survey data from 54 countries. The Lancet, 379(9822), 1225–1233.
Blencowe, H., Cousens, S., Modell, B., & Lawn, J. (2010). Folic acid to reduce neonatal mortality from neural tube disorders. International Journal of Epidemiology, 39(suppl_1), i110–i121.
Blom, H. J., Shaw, G. M., den Heijer, M., & Finnell, R. H. (2006). Neural tube defects and folate: case far from closed. Nature Reviews Neuroscience, 7(9), 724–731.
Chmielewska, A., Dziechciarz, P., Gieruszczak-Białek, D., Horvath, A., Pieścik-Lech, M., Ruszczyński, M., Skórka, A., & Szajewska, H. (2019). Effects of prenatal and/or postnatal supplementation with iron, PUFA or folic acid on neurodevelopment: update. British Journal of Nutrition, 122(s1), S10–S15.
Chowdhury, M. H. R. (2008). Neonatal deaths in a rural area of Bangladesh: An assessment of causes, predictors and health care seeking using verbal autopsy. Curtin University.
Dinga, L. A. (2013). Factors associated with adherence to iron/folate supplementation among pregnant women attending antenatal clinic at Thika District Hospital in Kiambu County, Kenya. University of Nairobi.
Fernandez, J. C. (2020). Securing a Healthy and Nutrition-Conscious Young Generation through the School and Community Education System for Society 5.0. Journal of Southeast Asian Education, 2020(2), 11–22.
Gao, Y., Sheng, C., Xie, R., Sun, W., Asztalos, E., Moddemann, D., Zwaigenbaum, L., Walker, M., & Wen, S. W. (2016). New perspective on impact of folic acid supplementation during pregnancy on neurodevelopment/autism in the offspring children–a systematic review. PloS One, 11(11), e0165626.
Gomes, S., Lopes, C., & Pinto, E. (2016). Folate and folic acid in the periconceptional period: recommendations from official health organizations in thirty-six countries worldwide and WHO. Public Health Nutrition, 19(1), 176–189.
Gómez-Pinilla, F. (2008). Brain foods: the effects of nutrients on brain function. Nature Reviews Neuroscience, 9(7), 568–578.
James-McAlpine, J. M. (2020). Micronutrient supplementation and birth outcomes in South-East Queensland.
Kirkpatrick, S. I., Baranowski, T., Subar, A. F., Tooze, J. A., & Frongillo, E. A. (2019). Best practices for conducting and interpreting studies to validate self-report dietary assessment methods. Journal of the Academy of Nutrition and Dietetics, 119(11), 1801–1816.
Lavanya, P., Jayalakshmy, R., Rajaa, S., & Mahalakshmy, T. (2020). Adherence to iron and folic acid supplementation among antenatal mothers attending a tertiary care center, Puducherry: A mixed-methods study. Journal of Family Medicine and Primary Care, 9(10), 5205–5211.
McCrory, C., & McNally, S. (2013). The effect of pregnancy intention on maternal prenatal behaviours and parent and child health: results of an irish cohort study. Paediatric and Perinatal Epidemiology, 27(2), 208–215.
Moore, L. D., Le, T., & Fan, G. (2013). DNA methylation and its basic function. Neuropsychopharmacology, 38(1), 23–38.
Morse, N. L. (2012). Benefits of docosahexaenoic acid, folic acid, vitamin D and iodine on foetal and infant brain development and function following maternal supplementation during pregnancy and lactation. Nutrients, 4(7), 799–840.
Mosca, L., Linfante, A. H., Benjamin, E. J., Berra, K., Hayes, S. N., Walsh, B. W., Fabunmi, R. P., Kwan, J., Mills, T., & Simpson, S. L. (2005). National study of physician awareness and adherence to cardiovascular disease prevention guidelines. Circulation, 111(4), 499–510.
Nakyajja, C. O. (2019). Preventing Neural Tube Defects and Promoting Health among Individuals with Neural Tube Defects and Their Families. The University of Wisconsin-Madison.
Ogundipe, O., Hoyo, C., Østbye, T., Oneko, O., Manongi, R., Lie, R. T., & Daltveit, A. K. (2012). Factors associated with prenatal folic acid and iron supplementation among 21,889 pregnant women in Northern Tanzania: a cross-sectional hospital-based study. BMC Public Health, 12, 1–10.
Petrova, E., Dewing, J., & Camilleri, M. (2016). Confidentiality in participatory research: Challenges from one study. Nursing Ethics, 23(4), 442–454.
Rahayu, S. K., Toyamah, N., Hutagalung, S. A., Rosfadhila, M., & Syukri, M. (2008). Qualitative baseline study for PNPM Generasi and PKH: The availability and use of the maternal and child health services and basic education services in the provinces of West Java and East Nusa Tenggara. SMERU Research Institute.
Richards, E., Theobald, S., George, A., Kim, J. C., Rudert, C., Jehan, K., & Tolhurst, R. (2013). Going beyond the surface: gendered intra-household bargaining as a social determinant of child health and nutrition in low and middle income countries. Social Science & Medicine, 95, 24–33.
Suchdev, P. S., Boivin, M. J., Forsyth, B. W., Georgieff, M. K., Guerrant, R. L., & Nelson III, C. A. (2017). Assessment of neurodevelopment, nutrition, and inflammation from fetal life to adolescence in low-resource settings. Pediatrics, 139(Supplement_1), S23–S37.
van Gool, J. D., Hirche, H., Lax, H., & De Schaepdrijver, L. (2018). Folic acid and primary prevention of neural tube defects: A review. Reproductive Toxicology, 80, 73–84.
van Wijngaarden, J. P., Dhonukshe-Rutten, R. A. M., van Schoor, N. M., van der Velde, N., Swart, K. M. A., Enneman, A. W., van Dijk, S. C., Brouwer-Brolsma, E. M., Zillikens, M. C., & van Meurs, J. B. J. (2011). Rationale and design of the B-PROOF study, a randomized controlled trial on the effect of supplemental intake of vitamin B 12 and folic acid on fracture incidence. BMC Geriatrics, 11, 1–11.
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