What is folate/ what is folic acid?
Folic acid and folate are usually used interchangeably, but they are biochemically different. Folate is the natural form of vitamin B9 which is naturally found in green leafy vegetables (such as kale and spinach), citrus fruits, and eggs.
Folic acid is a synthetic vitamin B9 dietary supplement that is present in artificially enriched foods and pharmaceutical vitamins. Simply put, folic acid is the synthetic version of folate, vitamin B9. In this article, we will specifically be talking about folic acid- a dietary supplement.
Why do pregnant women need to take folic acid supplements?
Folic acid is important in the formation of the nervous system of a growing baby. In the first few weeks of pregnancy, folic acid helps the embryonic neural tube (the precursor to your baby's brain and spinal cord) to properly close.
Additionally, folic acid is essential in DNA replication and amino acid formation (an important process in the formation of the developing baby's organs), and for the formation of red bloods cells. Dietary supplementation with folic acid during pregnancy is very important due to this increased demand. Folic acid deficiency is associated with severe consequences for the mother and the fetus which will be discussed later.
How much folic acid is needed and when should a pregnant woman start taking folic acid?
The Center for Disease Control and Prevention (CDC) recommends that women should take about 400 micrograms of folic acid before conception and during the first 12 weeks of pregnancy. Folic acid should ideally be taken daily throughout pregnancy. Research shows that taking a daily folic acid supplement of 400 micrograms reduces your baby's risk of developing neural tube defects by up to 70%.
The defects associated with folic acid deficiency happen during the first 28 days of pregnancy - usually before the woman even knows that she is pregnant. It is therefore important for all women of child- bearing age to ensure adequate folic acid intake through diet and supplementation.
Foods to incorporate into your diet include dark leafy green vegetables, avocado, legumes (black-eyed peas, green peas, and kidney beans), broccoli, asparagus, oranges, and foods that are fortified with folic acid, including whole grain breakfast cereal, bread, pasta and rice.
Folic acid deficiency
Folic acid deficiency in mothers is associated with anemia and peripheral neuropathy.
Folic acid deficiency in the fetus is associated with neural tube defects such as spina bifida, anencephaly, meningocele and tethered spinal cord syndrome.
spina bifida: when the spinal cord and the spinal column does not completely close
anencephaly: a severe underdevelopment of the brain
encephalocele: when brain tissue protrudes out to the skin through an opening in the skull
Tethered spinal cord syndrome is a neurological disorder caused by tissue attachments that limit the movement of the spinal cord within the spinal column.
These conditions have devastating consequences for the fetus and may lead to irreversible disability and may even result in death. Recent research has shown that folic acid deficiency can also lead to congenital heart defects, cleft palate, and pre-term birth. In pregnant women, folate deficiency can lead to anemia which can complicate pregnancy.
Take home message If you are planning on falling pregnant start taking folic acid supplements, and continue with the supplements for at least 12 weeks to avoid complications such as neural tube defects, cleft palate and congenital heart diseases in the growing baby.
This article is written by Dr Itumeleng Buti MBChB (Pret)
Comments