, Volume 28, Issue 11, pp 841-843
Date: 21 Nov 2013

Is folic acid a risk factor for oral clefts?

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There was a breakthrough in the primary prevention of neural-tube defects by periconceptional folic acid or folic acid-containing multivitamin supplementations during the last decades. In addition several studies showed some reduction of congenital heart defects, urinary tract defects and oral clefts as well due to folic acid or folic acid containing multivitamins use before and during the critical period of these congenital abnormalities [1]. However, the results of these studies were not confirmed in other studies, therefore did not stimulate public health action [2].

The paper of Rozendaal et al. [3] in this issue of EJE reported a new aspect—beyond the previous dilemma: effect or no effect of folic acid for the prevention of oral clefts—a higher risk for clefts, mainly cleft lip/alveolus in the children after maternal folic acid use during early pregnancy.

On the one hand, “unexpected is expected” is an old proverb in epidemiology. On the other hand the findings of this paper may ind ...