¹The Hospital for Sick Children, Toronto, ON, Canada

Abstract

Background: Prenatal supplementation with folic acid has been shown to decrease the risk of congenital malformations. Recent studies have suggested that they may also have a protective effect for pediatric cancers. As such we conducted a meta-analysis to assess the potential effect of folic acid fortified prenatal supplements on the occurrence of pediatric tumors and leukemias.

Methods: The meta-analysis was performed by searching Medline, PubMed, EMBASE, Toxline, Healthstar, and Cochrane databases for studies published in all languages from 1966-July 2005. References from all articles collected were reviewed for additional articles. Two blinded independent reviewers assessed the articles for inclusion and extracted the data from which the odds ratios and confidence intervals were calculated.

Results: Eight of the sixty-one articles were identified from the initial search provided extractable data on acute lymphoblastic leukemia (ALL), neuroblastoma, and pediatric brain tumours. Protective relationships were observed between multivitamin supplementation and ALL (OR=0.61, CI 95% 0.50-0.74), neuroblastoma (OR=0.53, CI 95% 0.42-0.68) and pediatric brain tumours (OR=0.94, CI 95% 0.83-1.07).

Conclusions: Maternal ingestion of prenatal multivitamins may be associated with a decreased risk for ALL and pediatric tumours such as neuroblastoma and brain tumours. This reinforces the need for prenatal multivitamin supplementation amongst women who are actively planning their pregnancy.