Folic Acid
The Vital Vitamin for Pregnancy
Prenatal vitamins are essential in the maintenance of a normal healthy pregnancy. These vitamins have a combination of vitamin and minerals, which along with a healthy diet support the needs of the pregnant woman, as well as the developing fetus. One of the most important components of the prenatal vitamin is Folic Acid.
Folic Acid is considered the “vital vitamin” in pregnancy, as it is associated with a decrease of 50 to 70 percent in the incidence of neural tube defects (NTD's). Neural tube defects are second only to cardiac defects in pregnancy occurring in 1/1000 pregnancies in the United States. Neural tube defects include spina bifida, which is an incomplete closure of the spinal cord as well as anencephaly, an absence of part or all of the skull and brain. These malformations are associated with moderate to severe disability or death in the infant. Folic acid supplements and dietary folic acid fortification decrease NTD's in patients having a first child, as well as those who have had a child with a NTD.
Folic Acid is derived from vitamin B9, also known as folate, one of the water-soluble “B complex” vitamins. While the terms folate and folic acid are used interchangeably; folic acid is a synthetic form of folate that is added to folic acid fortified foods such as breakfast cereal, pasta, bread, crackers, flour and fruit juices The levels of folic acid derived from supplements and fortified foods is substantially higher than that obtained from eating natural foods. The best sources of folate are found in organ meats such as beef liver, oranges, legumes, and green leafy vegetables like collard greens or spinach.
Neural tube formation occurs within the first month of pregnancy and has occurred before many women note that they are pregnant. Therefore, it is recommended that all women trying to become pregnant take a multivitamin with folic acid for 1-3 months prior to attempting a pregnancy. Indeed, many pregnancies are unplanned, so a recommendation that all reproductive age women take a multivitamin with folic acid is valid. Most multivitamin or prenatal vitamins will have .4 to .6 mg of folic acid. If a woman has had a child with a NTD, she should supplement with 4 mg of folic acid daily. This should be taken as a separate folic acid supplement, rather than increasing the number of multivitamins, which may increase the amount of other vitamins to dangerous levels. Folic acid supplementation should continue throughout the entire pregnancy.
Other women who may benefit from 4 mg of folic acid supplementation daily include those who take medications for epilepsy and women with pregestational diabetes (diabetes before pregnancy). Women who have a vegan diet are often recommended for the higher dose due to the fact that folate derived from natural vegetable sources do not provide levels that are seen in women who eat fortified foods and organ meats.
Prenatal care, moderate exercise, a healthy diet with folate rich or fortified foods, and a prenatal vitamin with folic acid, the vital vitamin, will help to maintain a healthy pregnancy.
