Evidence supporting the use of: Folic Acid
For the health condition: Miscarriage (prevention)

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Folic acid is most widely recognized for its role in preventing neural tube defects (NTDs) during fetal development. Its use in miscarriage prevention is based on scientific evidence, but the strength of that evidence is modest. Several observational studies have suggested an association between folic acid supplementation and reduced risk of miscarriage; however, the findings are inconsistent. A large meta-analysis (Ronnenberg et al., 2002; Gaskins et al., 2014) showed a possible modest reduction in miscarriage risk among women who took folic acid, but confounding factors (such as overall health and health-seeking behaviors) complicate interpretation.

Folic acid plays a crucial role in DNA synthesis, repair, and methylation, which are essential processes during embryonic development. Deficiencies in folate can lead to abnormal cell division and impaired placental development, which may contribute to pregnancy loss. Despite these mechanistic links, randomized controlled trials (RCTs) specifically examining folic acid for miscarriage prevention are limited, and no clear causal relationship has been firmly established. Most professional guidelines recommend folic acid supplementation for the prevention of neural tube defects, but do not specify its use solely for miscarriage prevention due to insufficient evidence.

In summary, while there is some scientific rationale and limited observational evidence supporting folic acid for miscarriage prevention, the evidence is not strong or conclusive. Its use is primarily justified for neural tube defect prevention, with potential but unproven benefits for miscarriage reduction.

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