Cerebral palsy is a lifelong disorder that affects movement, posture, and muscle control. It happens because of an injury or abnormal development of the brain that occurs during pregnancy, around the time of birth, or in the first years of life. Researchers have been trying to understand whether low folate levels in the mother during early pregnancy may be one of the factors that increase the risk of cerebral palsy in the child.
Folate, also known as vitamin B9, is essential for cell division, DNA synthesis, and healthy development of the fetal brain and nervous system. Folic acid is the synthetic form of folate used in supplements and food fortification. Public health authorities already recommend that women who might become pregnant take folic acid before conception and during early pregnancy to prevent neural tube defects such as spina bifida. Research funded by the NICHD showed that starting folic acid before conception and continuing through pregnancy can prevent most neural tube defects in babies, which are severe malformations of the brain and spinal cord https://www.nichd.nih.gov/about/accomplishments/contributions[3].
Because folate is so important for forming the nervous system, scientists have asked whether folate status might also influence broader neurodevelopmental outcomes, including cerebral palsy and other conditions. Inadequate dietary folate has been associated with abnormal fetal brain development, suggesting that deficiency could contribute to neurodevelopmental disorders in general https://www.adhdevidence.org/blog-tags/pregnancy[2]. A meta analysis of maternal folic acid supplementation and child outcomes found that appropriate folic acid use was linked with improved intellectual development and reduced risk of autism traits, ADHD, behavioral problems, and language difficulties in offspring[2]. This does not directly prove an effect on cerebral palsy, but it shows that folate status can influence how the brain develops and functions.
More recently, researchers have started to look specifically at the relationship between maternal folic acid supplementation and cerebral palsy. A study published in 2025 examined whether continuous maternal supplementation with folic acid around the time of conception was related to the risk of cerebral palsy in children https://www.tandfonline.com/doi/full/10.1080/09581596.2025.2605786[1]. The authors reported that the rate of cerebral palsy in children was lower when mothers took folic acid supplements continuously during the peri conceptional period[1]. In other words, regular folic acid use before and just after conception was associated with fewer cases of cerebral palsy. This kind of finding supports the idea that folate status in early pregnancy can influence the risk of serious motor disabilities, although it cannot prove cause and effect on its own.
It is important to understand that cerebral palsy usually does not have a single cause. It is most often the result of a combination of factors that either damage the developing brain or disrupt its normal growth. Preterm birth is one of the strongest known risk factors. A 2025 review highlighted that birth before 37 weeks of gestation is a critical risk factor for cerebral palsy, because the immature brain is more vulnerable to injury https://pmc.ncbi.nlm.nih.gov/articles/PMC12767667/[6]. Babies born very early or with very low birth weight have much higher rates of cerebral palsy than term infants[6]. Many other factors also contribute, including severe infections in pregnancy, lack of oxygen around the time of birth, significant jaundice, and some genetic or metabolic conditions.
Nutrition before and during pregnancy is one of the modifiable factors that can influence both maternal health and fetal development. Data from maternal and infant health programs point out that a large proportion of women of reproductive age are folic acid deficient, with estimates ranging from 60 percent to over 80 percent depending on race and population group https://www.motherbabynutrition.org/information[5]. Poor nutrition before pregnancy is linked to higher risk of miscarriage, stillbirth, birth defects, and preterm birth, and poor nutrition during pregnancy increases the chance of stillbirth, growth restriction, developmental delays, and other long term problems in the child[5]. Since preterm birth and developmental brain problems are both tied to cerebral palsy, this makes it biologically plausible that inadequate folate could indirectly raise cerebral palsy risk by contributing to these intermediate problems.
On the other hand, some of the most effective interventions to reduce cerebral palsy risk do not involve folate. For example, NICHD supported studies showed that giving magnesium sulfate to women at high risk of very preterm birth can help prevent cerebral palsy and other types of brain injury in their infants[3]. Monitoring and managing low umbilical cord pH at birth, treating severe jaundice early, preventing infections, and optimizing neonatal intensive care have also lowered the risk of brain injury and cerebral palsy in preterm and sick newborns https://www.contemporaryobgyn.net/clinical/pediatrics[4][3]. These findings show that cerebral palsy prevention is a broad field where folate is likely one piece of a larger puzzle.
So what can we say specifically about low maternal folate and cerebral palsy risk based on current evidence?
First, low folate or inadequate folic acid intake is clearly linked with neural tube defects, which are severe abnormalities of the brain and spine, and preventing these defects is an established reason for folic acid supplementation[3]. Second, low folate is associated with abnormal fetal brain development more generally, and appropriate supplementation has been linked to better neurodevelopmental outcomes and fewer behavioral and cognitive problems in children[2]. Third, at least one recent study has found that continuous folic acid supplementation around conception is associated with a lower rate of cerebral palsy in offspring[1]. Together, these findings suggest that having adequate folate in early pregnancy is likely beneficial for reducing the risk of serious neurological problems, and that insufficient folate could be one of several factors that increase the likelihood of cerebral palsy.
However, the relationship is not as clear or as strong as it is for neural tube defects. Not all children with cerebral palsy were born to mothers with low folate levels, and not all women with folate deficiency give birth to a child with cerebral palsy. Cerebral palsy usually arises from a
