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

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Synopsis

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

Folinic acid (a form of Vitamin B9, distinct from folic acid) is sometimes used in the context of miscarriage prevention, but the evidence supporting its use is limited and largely extrapolated from broader research on folate and folic acid in pregnancy. Folate deficiency is associated with neural tube defects and other pregnancy complications, and routine supplementation with folic acid (not specifically folinic acid) is a standard public health measure to reduce neural tube defects. Some studies suggest that folate deficiency may also increase the risk of spontaneous abortion (miscarriage), but direct evidence that supplemental folinic acid reduces miscarriage rates is lacking.

Folinic acid is occasionally used in women with genetic mutations affecting folate metabolism (such as MTHFR mutations), which could theoretically impact pregnancy outcomes, but robust clinical trials showing a reduction in miscarriage risk with folinic acid supplementation are absent. Most guidelines recommend regular folic acid, not folinic acid, for preconception and early pregnancy support. Therefore, while there is a plausible biological rationale for folate's general importance in pregnancy, and some indirect evidence suggesting a role in miscarriage prevention, the specific use of folinic acid for this purpose is not strongly supported by high-quality scientific evidence.

References:
- De-Regil LM, et al. "Effects and safety of periconceptional folate supplementation for preventing birth defects." Cochrane Database Syst Rev. 2015.
- Czeizel AE, Dudas I. "Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation." N Engl J Med. 1992.
- Practice guidelines from the American College of Obstetricians and Gynecologists (ACOG).

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