Top 5 recent updates in folic acid research

As we recognize National Folic Acid Awareness Week (September 8-14, 2025), it is vital to discuss innovations, research, and evolving care strategies that will influence folic acid management. From its influence on birth defects to increased use in gestation diabetes patients, groundbreaking folic acid research has emerged throughout 2025.

In this roundup, Contemporary OB/GYN highlights some of the most notable folic acid-related developments so far this year, including supplement use before pregnancy and improved child development. These stories highlight an ongoing effort to highlight the benefits of folic acid supplementation and increase use in the general population.

Click on each title below for more information on each news item.

A multicenter randomized clinical trial evaluated the impact of 3 surgical approaches for vaginal vault prolapse repair on body image and sexual function: native tissue repair, sacrocolpopexy, and transvaginal mesh. The study included 335 women, with a mean age of 66 years, most of whom had stage 3 prolapse.

Using the Body Image in Pelvic Organ Prolapse questionnaire and sexual function measures, investigators found significant improvements in body image and sexual function across all surgical methods over 36 months. No significant differences emerged between approaches, nor between mesh vs non-mesh or vaginal vs abdominal procedures.

Women who remained or became sexually active post-surgery reported greater gains in sexual function, with improvements closely tied to better body image. However, 37% experienced surgical failure by 36 months, which was associated with poorer body image. Overall, findings highlight that prolapse repair enhances body image and sexual health regardless of surgical technique.

A national analysis published in the American Journal of Preventive Medicine found that two-thirds of US women of reproductive age present with at least 1 modifiable risk factor for birth defects. Among 5,374 nonpregnant, nonlactating women studied from 2007 to 2020, 19.5% had low red blood cell folate levels, 33.8% were obese, 4.8% had diabetes, and nearly 1 in 5 had tobacco exposure.

Supplement use was low, with only 12.6% meeting recommended folic acid intake, and nearly all participants fell below 400 µg/day without supplements. Over time, obesity, diabetes, prediabetes, and very low food security increased, while active tobacco use and adequate folic acid intake declined.

Disparities were noted, with non-Hispanic Black and Hispanic women more likely than White women to have risk factors. Investigators emphasized that addressing these preventable factors through improved nutrition, health care access, and preconception counseling could significantly reduce the risk of birth defects and improve pregnancy outcomes.

A national survey conducted by the Annenberg Public Policy Center in April 2025 revealed persistent gaps in US adults’ knowledge of pregnancy-related health recommendations, despite broad recognition of maternal health’s importance. Among 1,653 respondents, 91% acknowledged pregnancy health affects infants, yet knowledge of specific guidelines was inconsistent and declining in some areas.

Only 46% correctly identified the recommended weight gain of 25 to 35 pounds during pregnancy, and understanding of folic acid supplementation dropped from 76% in 2023 to 71%. Awareness of iron use, alcohol abstinence prior to conception, and secondhand smoke risks also showed significant gaps, particularly among women of childbearing age.

Knowledge of vaccine recommendations declined, with just 37% recognizing Tdap as recommended and only 11% aware that MMR is contraindicated in pregnancy. These findings highlight the need for stronger, targeted public health messaging to address misconceptions and support healthier pregnancies, especially among reproductive-aged women and their families.

A study presented at the American Academy of Neurology’s 77th Annual Meeting found that higher maternal folic acid intake during the first trimester is linked to improved verbal and behavioral outcomes in children at age 6 years. The analysis included 345 children, most born to women with epilepsy, and compared outcomes based on maternal folic acid doses ranging from none to more than 4 mg per day.

Children whose mothers took folic acid scored higher in verbal skills (mean 108 vs 96) and behavior (102 vs 82) compared with those whose mothers took none. Among folic acid users, verbal scores averaged 110 for high-dose vs 108 for low-dose groups, with behavioral scores similar at 103.

These findings suggest that folic acid intake, regardless of dose, benefits neurodevelopment, while higher doses appear safe. Investigators emphasized the importance of early supplementation for child brain health, particularly in women at higher risk, such as those with epilepsy.

A study published in Gynecological Endocrinology suggests that a multi-layer perceptron (MLP) deep learning model may improve prediction of gestational diabetes mellitus (GDM) compared with traditional logistic regression approaches. GDM affects 5% to 30% of pregnancies worldwide, varies by region and ethnicity, and poses serious risks for both mothers and infants.

Investigators conducted a retrospective cohort study of pregnant women delivering between 2008 and 2018, analyzing 32 prenatal variables, including age, prepregnancy body mass index (BMI), folic acid supplementation, family history, and laboratory biomarkers. Women with GDM were more likely to be older, have higher BMI, lower education, earlier menarche, and distinct hematological, renal, and liver profiles.

The MLP model, structured with 3 neural network layers, demonstrated superior predictive performance with an area under the receiver operating characteristic curve of 0.943, average precision of 0.855, and F1 score of 0.879, compared to weaker results from logistic regression models. Investigators noted that incorporating genetic data could further refine prediction and support personalized prevention and treatment strategies for GDM.