Folic acid in pregnancy
Folic acid is used to
produce the extra blood your body needs during pregnancy. All women of
childbearing age should consume 400 to 800 micrograms (0.4 to 0.8 mg) of folic
acid daily.
When should I start taking folic acid?
You should start taking
folic acid before you become pregnant, even if you are not trying to get
pregnant. Neural tube defects usually develop during the first 28 days of
pregnancy, often before a woman even knows she is pregnant.
If you find that you
are pregnant and have not taken folic acid, you should start right away to
prevent any nerve abnormalities in the first three months of pregnancy.
What is the difference between folic acid and folic acid?
People often use them
interchangeably since they are both forms of vitamin B9, but there is actually
an important difference between the two. Folic acid is the synthesized version
commonly used in processed foods and supplements. Folate can be found in whole
foods such as leafy vegetables, eggs, and citrus fruits. Unfortunately, a large
percentage of women (up to 60%) have a defect in the MTHFR gene that prevents
them from properly converting synthetic folic acid to active methylfolate.
Thus, women taking folic acid may not absorb the B vitamins properly. For this
reason, it is best to take folic acid from whole food sources or supplements
containing the natural form of active folate rather than synthesized folic acid
whenever possible.
What are the risks of not taking folic acid?
A lack of folic acid
increases the chance of a neural tube defect (a defect in the development of
the spinal cord).
Spina bifida is a
condition in which the spinal cord is exposed. If the vertebrae (spinal bones)
surrounding the spinal cord do not close properly during the first 28 days
after fertilization, the spinal cord or cerebrospinal fluid swells, usually in
the lower back.
Anencephaly is a
serious underdevelopment of the brain.
What foods contain folic acid?
The following foods
may help you get your recommended amount of folic acid:
- Leafy green vegetables, such as spinach
- Citrus fruits, such as orange juice
- Beans
- Bread
- Cereals
- Rice
- Pasta
Your doctor may
recommend taking a daily folic acid vitamin because the foods listed above may
not contain enough folic acid to meet your daily requirement.
How do I know if I'm at risk of having a baby with nerve abnormalities, and how can I prevent it?
Women at greatest
risk are those who have already had a pregnancy associated with the nerve
abnormality. Women who do not eat a balanced diet that includes folic acid are
also at risk.
The best way to
prevent nerve abnormalities is to take the recommended 400 to 800 micrograms
(0.4 to 0.8 milligrams) of folic acid daily for one month before conception and
during the first three months of pregnancy. The daily dose should not exceed
1000 mcg (1.0 mg).
Multivitamins
containing folic acid should only be used as a supplement under the supervision
of a physician.
How are neural tube defects diagnosed?
Neural tube defects
are detected using an alpha-fetoprotein (AFP) test. Alpha-fetoprotein is a
blood test that is given at 16-18 weeks of pregnancy. The test measures
alpha-fetoprotein, a substance produced by the fetus and secreted into the
amniotic fluid.
Alpha-fetoprotein is
also found in the mother's blood. The peak level of alpha-fetoprotein in the
mother's blood falls at around 30-32 weeks. An abnormally high amount of
alpha-fetoprotein may indicate that the baby has a neural tube defect.
What are other causes of high alpha-fetoprotein levels?
A high level of alpha-fetoprotein
may mean that the mother is carrying twins or there is a problem with the
placenta. Women with diabetes or liver disease may also have high
alpha-fetoprotein levels.
However, high levels
of AFP can also mean birth defects such as severe kidney disease, liver
disease, blockage in the esophagus or intestines, Down's syndrome, urinary
tract obstruction, or osteogenesis imperfecta (weakness of the baby's bones).
If I have a high
alpha-fetoprotein level, what additional tests are available?