Folic Acid and Pregnancy

Throughout residency and in practice, I have seen many pregnant women. One of the most important pieces of advice I provide is the need to take a prenatal vitamin, more importantly, folic acid.

Folic acid is a B9 vitamin, essential in cellular production and division. It is found in green leafy vegetables, orange juice, dry beans, spinach, bananas, peanuts, enriched whole grain foods, and kale. The recommended daily allowance is 400 micrograms/day. Folic acid can help prevent coronary heart disease, anemia, and, in babies, neural tube defects.

Neural tube defect is a condition when the baby sustains a birth defect where there is incomplete development of the brain and spinal cord. Examples include spina bifida, anencephaly, and encephalocele. Typically, these defects occur in the first month of pregnancy, when the mother is unaware of her pregnancy. Folic acid can reduce the incidence of neural tube defects by up to 70%. Unfortunately, about 3000 babies are born each year with a neural tube defect.

The recommended dose for women who are pregnant or are expecting to be pregnant is 400 micrograms per day. Adequate folic acid intake should begin for all women who are of child-bearing age. It is wise to start a prenatal vitamin one month prior to conception to help ensure fetal nerve and brain development. One study indicated that three out of four women did not take their vitamin at least four times a week in the month before they became pregnant.

Folic acid can also reduce the possibility of cleft palates, preeclampsia, premature birth, congenital heart defects, and miscarriage.

There are special circumstances when more folic acid supplementation is required. Examples include previous child with a neural tube defect, family history of neural tube defects, personal history of diabetes, seizure disorder, or rheumatoid arthritis.

Folic acid supplementation does not stop at the birth. During breast feeding, the recommended amount is 500 mcg daily.

Typically prenatal vitamins contain 400mcg of folic acid. Most multivitamins also contain 400mcg. Check the label and verify that it has 100% of the RDA (recommended daily allowance).

Talk to your health care professional for more information. Thank you and have a nice day.