Evidence supporting the use of: Vitamin B9 (folic acid/folate)
For the health condition: Miscarriage (prevention)

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Synopsis

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

Vitamin B9 (folic acid/folate) is widely recommended for women who are pregnant or trying to conceive, primarily to prevent neural tube defects in the developing fetus. Its role in the prevention of miscarriage, however, is less clearly established. Multiple observational studies have explored the association between folate status and miscarriage risk, but results are mixed. Some studies suggest that low maternal folate levels may be associated with an increased risk of spontaneous abortion, possibly due to its role in DNA synthesis, repair, and methylation—all crucial for fetal development and placental function. However, randomized controlled trials (RCTs) specifically targeting miscarriage prevention with folic acid supplementation are limited and have not consistently demonstrated a significant reduction in miscarriage risk. Clinical guidelines universally recommend folic acid supplementation before and during early pregnancy to prevent neural tube defects, but they do not strongly endorse its use specifically for miscarriage prevention. The evidence supporting folic acid in reducing miscarriage risk is therefore considered weak to moderate at best, and its use for this indication is based more on potential biological plausibility and observational data than on robust clinical trial evidence. Nevertheless, due to its established safety and clear benefits for fetal neural development, folic acid continues to be recommended for women of reproductive age.

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