Folic acid and orofacial clefts: a review of the evidence

• Published in: Oral diseases Vol. 16; no. 1; pp. 11 - 19
• Main Authors: Wehby, GL, Murray, JC
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.01.2010
• Subjects: cleft lip; Cleft Lip - genetics; Cleft Lip - prevention & control; Cleft Palate - genetics; Cleft Palate - prevention & control; Clinical Trials as Topic; folate; folic acid; Folic Acid - therapeutic use; Gene Expression Regulation, Developmental; Humans; Neural Tube Defects - prevention & control; Orofacial clefts; prevention; randomized clinical trials; Vitamin B Complex - therapeutic use
• ISSN: 1354-523X; 1601-0825
• DOI: 10.1111/j.1601-0825.2009.01587.x

Orofacial clefts are common and burdensome birth defects with a complex genetic and environmental etiology. The contribution of nutritional factors and supplements to the etiology of orofacial clefts has long been theorized and studied. Multiple studies have evaluated the role of folic acid in the occurrence and recurrence of orofacial clefts, using observational and non‐randomized interventional designs. While preventive effects of folic acid on orofacial clefts are commonly reported, the evidence remains generally inconsistent. This paper reviews the findings of the main studies of the effects of folic acid on orofacial clefts, summarizes study limitations, and discusses research needs with a focus on studying the effects of high dosage folic acid on the recurrence of oral clefts using a randomized clinical trial design. The role of folic acid in the prevention of neural tube defects is also briefly summarized and discussed as a reference model for orofacial clefts.