A meta-analysis of the effects of folic acid supplementation on pregnancy outcomes in pregnant women with epilepsy
HOU Jiajia
YANG Ziyi
MA Xiao
WANG Zitong
WANG Xuan
SONG Changgeng
JIANG Wen
Abstract：Objective To systematically evaluate the effect of folic acid supplementation on pregnancy outcomes in pregnant women with epilepsy.Methods A systematic search was performed in PubMed,Embase,Cochrane Library,CNKI,WanFang Data,VIP,and Sino Med databases from their inception to December 31,2025.A meta-analysis was conducted to assess maternal and neonatal outcomes associated with folic acid supplementation in pregnant women with epilepsy,with a sensitivity analysis performed for those taking anti-seizure medications(ASM).Results Seventeen studies were included.The meta-analysis showed that folic acid supplementation reduced the risks of adverse neurodevelopmental outcomes[OR=0.38,95%CI(0.20,0.70),P=0.002]and adverse perinatal outcomes[OR=0.41,95%CI(0.21,0.78),P=0.007].However,it did not reduce the occurrence of congenital malformations[OR=0.99,95%CI(0.54,1.83),P=0.975],and was associated with an increased risk of cancer in offspring[OR=2.29,95%CI(1.27,4.13),P=0.006].Among pregnant women with epilepsy receiving ASM treatment,folic acid supplementation was associated with improved neurodevelopmental outcomes,but had no significant impact on perinatal outcomes or congenital malformations.Conclusion Folic acid supplementation may improve neurodevelopmental outcomes in the offspring of pregnant women with epilepsy.However,its impact on perinatal outcomes remains unclear,it does not reduce the risk of congenital malformations,and it may be associated with an increased risk of cancer in offspring.Further high-quality research is needed to clarify its specific effects.
Keywords：folic acidepilepsypregnancy outcomeperinatal periodneurodevelopmentcongenital malformationsneoplasmsmeta-analysis
Publication Date：2026-05-31
Online Publishing Date：2026-08-26(First online date of this platform, not the publication date of the document)
Pages：7( 741-747 )