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Why is folic acid so important in pregnancy?

Monday March 16, 2020
Why is folic acid so important in pregnancy?

Photo: Folate can be found in leafy green vegetables.  

 

What is folic acid?


Folic acid is a contributor to the development of a healthy foetus, reducing neural tube defects (spina bifida) and contributes to the brain development. (1)

Folic acid is the main form of folate. Folate also known as vitamin B9 is naturally found in certain foods including fruits, vegetables, and nuts, whereas folic acid is found in vitamins and fortified foods both of these help the body make healthy new red blood cells, (1)

Folate is an essential nutrient; it is required for DNA replication. Folate is the generic name for chemically related compounds based on a folic acid structure. (1)

Foods containing folate

=         Cooked dried beans
=         Leafy green vegetables
=         Fortified cereals
=         Peas
=         Nuts
=         Turnip greens
=         Okra
=         Brussel sprouts
=         Citrus fruit and juice
=         Organ meats (liver and kidney)

 



Why might you be deficient of folate?


Folate deficiency can occur as a consequence of not having enough folate in your diet or as metabolic requirement for folate is increased by a particular genetic defect. Poor folate status such as smoking, use of alcohol or oral contraceptives are associated with low concentrations of folate. (3)


Consequences of not having enough during pregnancy can lead to complications in birth. Preterm birth delivery can occur prior to 37 weeks of gestation. Symptoms of Preterm Birth (PTB) can cause short term respiration, gastrointestinal issues as well as cognitive and cause mortality and morbidity to rise.

Neural tube defects (NTD) can occur in women who have a family history of NTD or a prior child with NTD. If the mother is on anticonvulsant medication this can put them at high risk. As a prevention, supplementing with 5mg of folic acid daily, prior to conception should be taken. (2)

How much folic acid is needed for pregnancy?

The suggested dose is to supplement 400mcg of folic acid daily before pregnancy until 12 weeks left of pregnancy. Some women may require higher doses of folic acid and should consult with a GP to get a recommended amount - this usually tends to be 5mg. (1)

The Scientific Advisory Committee on Nutrition (SACN) supported a previous recommendation for mandatory folic acid fortification to improve folate status of women most at risk of NTD-affected pregnancies.

What do studies show?

Studies have shown folic acid to protect against PTB when consumed one year prior to conception. The following study shows dosage to be just as effective as the duration of folic acid intake. (3)

An observational study by Scholl et al, of folate from diet and supplements and serum folate was assessed in pregnant women. Women with low folate intake of less than 240ug daily had three times greater preterm delivery and infant low birth weight than those with higher intakes of folate of more than 240ug daily. (3)

Low intakes from diet and supplements were associated with maternal characteristics including poor nutritional status, low energy intake, low rate of gestational weight gain, high levels of iron deficiency anaemia at prenatal care. (3)

Concluding


In summary poor dietary folate intake and low supplementation are associated with adverse birth outcomes. Many women are shown to have positive benefits from receiving additional folic acid during and prior to pregnancy. (3)

If you are planning a pregnancy or are currently pregnant and at the start of your pregnancy, an organic folic acid supplement may be something to consider. If you think you are too late on in the pregnancy to take a folic acid supplement, speak with your GP to get a recommendation of how much is suitable.

Author: Rupinder Dhanjal is a Technical Advisor at Viridian Nutrition. She holds a BSc in Nutrition and Health.

References

(1) NHS (2018) Why do I need folic acid in pregnancy? [online] available from  https://www.nhs.uk/common-health-questions/pregnancy/why-do-i-need-folic-acid-in-pregnancy [17th February 2020]


(2) Greenberg, J.A., Bell, S.J., Guan, Y and Yu, H.H (2011) Folic Acid Supplementation and Pregnancy: More Than Just Neural Tube Defect Prevention. Obstetrics and Gynecology. 4 (2), pg 52-59 [online] available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3218540 [17th February 2020]


(3) Scholl, T.O and Johnson, W.G (2000) Folic acid: influence on the outcome of pregnancy. The American Journal of Clinical Nutrition. 71 (5), pg 1295S-1303S [online] available from https://academic.oup.com/ajcn/article/71/5/1295S/4729437 [17th February 2020] 



This article is for information purposes and does not refer to any individual products. The information contained in this article is not intended to treat, diagnose or replace the advice of a health practitioner. Please consult a qualified health practitioner if you have a pre-existing health condition or are currently taking medication. Food supplements should not be used as a substitute for a varied and balanced diet.

 

TAGS: PregnancyPregnancy

 

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