Child's Nervous System

, Volume 26, Issue 12, pp 1727–1733 | Cite as

Case control study of periconceptional folic acid intake and nervous system tumors in children

  • Juan Antonio Ortega-GarcíaEmail author
  • Josep Ferrís-Tortajada
  • Luz Claudio
  • Offie Porat Soldin
  • Miguel Felipe Sanchez-Sauco
  • Jose Luís Fuster-Soler
  • Juan Francisco Martínez-Lage
Original Paper



Since 1992, the Centers for Disease Control and Prevention recommends that women of childbearing age consume 400 µg of folic acid per day to reduce the risk of neural tube defects (NTD). It has been speculated that both NTD and nervous system tumors (NST) may share common mechanisms of altered development. It examines the association between folic acid supplementation and the risk for childhood NST.


Incident cases of children with cancer in Spain registered between 2004 and 2006 were identified through the MACAPE Network Group. Tumors were classified as tumors derived from the neuroectoderm (cases) and those with a mesoderm origin (controls). In a second analysis, NST were further divided into central nervous system tumors (CNST) and sympathetic nervous system tumors (SNST). We compared folic acid supplementation between the groups.


Overall, folic acid supplementation any time during pregnancy was similar between cases and controls (odds ratio (OR) = 1.05; 95% confidence interval (CI) 0.92–1.20). However, supplementation before the 21st and 36th days of gestation resulted in significantly lower NST than in children with mesoderm tumors (OR = 0.34; 95% CI 0.17–0.69 and OR = 0.58; 95% CI 0.37–0.91, respectively). Preconceptional intakes of folic acid were also lower in NST although marginally nonsignificant (OR = 0.44; 95% CI 0.10–1.02). When NST were divided into CNST and SNST, significant differences between tumors of mesoderm origin were only found for CNST.


Our results support the hypothesis that folate supplementation reduces the risk of childhood NST, especially CNST. The specific mechanism and cellular role that folate may play in the development of CNST have yet to be elucidated.


Folic acid Folate supplementation Pediatric cancer Nervous system tumors 



The authors express their gratitude for the support and funding granted by the Scientific Foundation of the AECC (Asociación Española Contra el Cáncer). Additionally, we thank Isaedmarie Fevo and Rayden Llano from the Mount Sinai International Exchange Program for Minority Students. Their work is supported by grant MD001452 from the National Center on Minority Health and Health Disparities of the National Institutes of Health.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Juan Antonio Ortega-García
    • 1
    Email author
  • Josep Ferrís-Tortajada
    • 2
  • Luz Claudio
    • 3
  • Offie Porat Soldin
    • 4
  • Miguel Felipe Sanchez-Sauco
    • 1
  • Jose Luís Fuster-Soler
    • 5
  • Juan Francisco Martínez-Lage
    • 6
  1. 1.Paediatric Environmental Health Speciality Unit, Translational Cancer Research CenterUniversity Hospital Virgen of ArrixacaMurciaSpain
  2. 2.Paediatric Environmental Health Speciality UnitChildren’s University Hospital La FeValenciaSpain
  3. 3.Department of Community and Preventive MedicineMount Sinai School of MedicineNew YorkUSA
  4. 4.Departments of Oncology, Medicine, Physiology and BiophysicsGeorgetown University Medical CenterWashingtonUSA
  5. 5.Paediatric Oncology SectionUniversity Hospital Virgen of ArrixacaMurciaSpain
  6. 6.Regional Service of NeurosurgeryUniversity Hospital Virgen of ArrixacaMurciaSpain

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