Why do pregnant women need folic acid

Folic Acid | CDC

CDC urges all women of reproductive age to take 400 micrograms (mcg) of folic acid each day, in addition to consuming food with folate from a varied diet, to help prevent some major birth defects of the baby’s brain (anencephaly) and spine (spina bifida).

About folic acid

Folic acid is a B vitamin. Our bodies use it to make new cells. Think about the skin, hair, and nails. These–and other parts of the body – make new cells each day. Folic acid is the synthetic (that is, not generally occurring naturally) form of folate used in supplements and in fortified foods such as rice, pasta, bread, and some breakfast cereals

Why folic acid is important before and during pregnancy

When the baby is developing early during pregnancy, folic acid helps form the neural tube. Folic acid is very important because it can help prevent some major birth defects of the baby’s brain (anencephaly) and spine (spina bifida). The neural tube forms the early brain and spine.

Women of reproductive age need 400 mcg of folic acid every day

All women of reproductive age should get 400 mcg of folic acid every day to get enough folic acid to help prevent some birth defects because
- About half of U.S. pregnancies are unplanned, and
- Major birth defects of the baby’s brain or spine occur very early in pregnancy (3-4 weeks after conception), before most women know they are pregnant.

When taking folic acid, a higher dose than 400 mcg of folic acid each day is not necessarily better to prevent neural tube defects, unless a doctor recommends taking more due to other health conditions.
- When planning to become pregnant, women who have already had a pregnancy affected by a neural tube defect should consult with their healthcare provider. CDC recommends that these women consume 4,000 mcg of folic acid each day one month before becoming pregnant and through the first 3 months of pregnancy.

Learn more about CDC’s folic acid recommendations here.
Learn more about the recommended intake level of folic acid here.

When to start taking folic acid

Every woman of reproductive age needs to get folic acid every day, whether she is planning to get pregnant or not, to help make new cells.

Are folate and folic acid the same thing?

The terms “folate” and “folic acid” are often used interchangeably, even though they are different. Folate is a general term to describe many different types of vitamin B9.

Types of folate can include

Dihydrofolate (DHF)
Tetrahydrofolate (THF)
5, 10-methylenetetrahydrofolate (5, 10-Methylene-THF)
5-methyltetrahydrofolate (5-Methyl-THF or 5-MTHF)

Food fortification is a way to add vitamins or minerals, or both, to foods. Some rice, pasta, bread, and breakfast cereals are fortified with folic acid. These foods are labeled “enriched.” Folic acid is a specific type of folate that does not generally occur naturally.

Folic acid is the ideal form of folate to use for food fortification. It is more stable than types of natural food folate, which can easily be broken down by heat and light. Folic acid is better suited for food fortification because many fortified products, such as bread and pasta, are cooked.⁶

CDC recommends that women of reproductive age who could become pregnant consume at least 400 micrograms (mcg) of folic acid every day. However, it’s difficult to get 400 mcg of folic acid through diet alone. You can get 400 mcg of folic acid each day by taking a vitamin with folic acid in it, eating fortified foods, or a combination of the two, in addition to consuming a balanced diet rich in natural food folate.

How to get enough folic acid to prevent neural tube defects

In addition to eating foods with folate from a varied diet, women can get folic acid from

Taking a vitamin that has folic acid in it:
- Most vitamins sold in the United States have the recommended daily amount of folic acid (400 mcg) that women need for the prevention of neural tube defects. Vitamins can be found at most local pharmacy, grocery, or discount stores.
Eating fortified foods:
- You can find folic acid in some breads, breakfast cereals, and corn masa flour.
Getting a combination of the two: taking a vitamin that has folic acid in it and eating fortified foods.

If taking folic acid for reasons other than neural tube defect prevention, talk to your healthcare provider.

Learn more about where to find folic acid in the United States here.

More Information

For more information, visit the Frequently Asked Questions page.

You can also contact CDC-INFO in English or Spanish:

1-800-CDC-INFO (800-232-4636)
TTY: 1-888-232-6348
In English
en español

Folic Acid Benefits in Pregnancy

Written by Stephanie Watson

Reviewed by Traci C. Johnson, MD on August 12, 2022

What Is Folic Acid?

Folic acid is a man-made form of a B vitamin called folate. Folate plays an important role in the production of red blood cells and helps your baby's neural tube develop into their brain and spinal cord. The best food sources of folic acid are fortified cereals. Folate is found naturally in dark green vegetables and citrus fruits.

When Should I Start Taking Folic Acid?

Birth defects occur within the first 3-4 weeks of pregnancy. So it's important to have folate in your system during those early stages when your baby's brain and spinal cord are developing.

If you talked to your doctor when you were trying to conceive, they probably told you to start taking a prenatal vitamin with folic acid. One study showed that women who took folic acid for at least a year before getting pregnant cut their chances of delivering early by 50% or more.

The CDC recommends that you start taking folic acid every day for at least a month before you become pregnant, and every day while you are pregnant. However, the CDC also recommends that all women of childbearing age take folic acid every day. So you'd be fine to start taking it even earlier.

If you picked out your own prenatal vitamin, take it to your OB once you're pregnant to make sure it has the recommended amounts of everything you need, including folic acid. All prenatal vitamins are not the same and some may have less or more of the vitamins and minerals you need.

How Much Folic Acid Should I Take?

The recommended dose for all women of childbearing age is 400 mcg of folate each day. If you take a multivitamin every day, check to see if it has the recommended amount. If for some reason you don't want to take a multivitamin, you can take folic acid supplements.

Here's how much folic acid is recommended each day in terms of pregnancy:

While you're trying to conceive: 400 mcg
For the first three months of pregnancy: 400 mcg
For months four to nine of pregnancy: 600 mcg
While breastfeeding: 500 mcg

What Are the Benefits of Folic Acid?

Without enough folic acid in your body, your baby's neural tube may not close correctly and they could develop health problems called neural tube defects. These include:

Spina bifida: incomplete development of the spinal cord or the vertebrae
Anencephaly: incomplete development of major parts of the brain

Babies with anencephaly usually do not live long, and those with spina bifida may be permanently disabled. These are scary problems, to say the least. But the good news is that getting enough folic acid may protect your baby from neural tube defects by at least 50%. According to the CDC, if you've already had a baby with a neural tube defect, getting enough folic acid may reduce your risk of having another child with a neural tube defect by as much as 70%. If you have had a previous child with a neural tube defect, tit is recommended that you increase your daily amount of folic acid to 4000 mcg (same as 4 mg) each day. Check with your doctor about how much you should take.

When taken before and during pregnancy, folic acid may also protect your baby against:

Cleft lip and palate
Premature birth
Low birth weight
Miscarriage
Poor growth in the womb

Folic acid has also been suggested to reduce your risk of:

Pregnancy complications (One report found that women who took folic acid supplements during the second trimester had a reduced risk of preeclampsia. )
Heart disease
Stroke
Some types of cancers
Alzheimer’s disease

Good Food Sources of Folic Acid

Foods that can help you get more folic acid in your diet include:

400 mcg: Breakfast cereals fortified with 100% of the DV, 3/4 cup
215 mcg: Beef liver, cooked, braised, 3 oz
179 mcg: Lentils, mature seeds, cooked, boiled, 1/2 cup
115 mcg: Spinach, frozen, cooked, boiled, 1/2 cup
110 mcg: Egg noodles, enriched, cooked, 1/2 cup
100 mcg: Breakfast cereals, fortified with 25% of the DV, 3/4 cup
90 mcg: Great Northern beans, boiled, 1/2 cup

Folic acid in pregnancy planning: benefits, dosage, consequences of deficiency

During the bearing of a child, the female body consumes vitamins, trace elements in large quantities. All useful substances are needed, but folic acid plays an important role in planning pregnancy. How much folic acid do you need to take to get pregnant, carry a baby? Do men need to take vitamin B9 when planning to conceive? Read the article.

Why the body needs vitamin B9

B9 is a water soluble vitamin. It enters the body with food and is synthesized in the intestines. The main role of vitamin B9 is participation in the creation and maintenance of the functioning of new cells. Therefore, folic acid when planning pregnancy is one of the prerequisites for successful conception.

Functions:

participates in DNA replication, production of erythrocytes and leukocytes;
need folic acid before pregnancy - affects the production of ribonucleic acid, RNA is contained in the cell nucleus, is involved in the coding and expression of genes;
promotes the absorption of proteins, other vitamins;
is part of the synthesis of neurotransmitters that regulate appetite, sleep;
supports fertility functions in women and men;
has an antioxidant effect, prevents the formation of malignant tumors;
helps to strengthen the protective functions of the body;
reduces the risk of developing atherosclerosis.

Vitamin B9 is included in the complex therapy in the treatment of disorders in the immune system, diabetes mellitus, intestinal diseases, inflammatory processes in the oral cavity and dermatological diseases.

Regular intake of folic acid is essential for people over 50 years of age. The substance improves sleep, stabilizes blood pressure, reduces the risk of diabetes. Vitamin B9 is necessary for the prevention of heart attack, heart disease and blood vessels, accelerating the process of cell regeneration, maintaining healthy skin and hair.

Important! Folates normalize the menstrual cycle, delay the onset of menopause. Affect ovulation - with regular use, anovulatory cycles are less common.

Pregnancy benefits

Doctors recommend that both parents take folic acid when planning a pregnancy 3-4 months before conception. This will help reduce the risk of developing various pathologies in the fetus and diseases in the mother.

The substance is involved in the laying of the cardiovascular, nervous system of the fetus, the work of immunity, affects hematopoiesis. With a deficiency, the facial bones are formed incorrectly, the child is born with a "cleft lip". With a lack of vitamin B9a newborn is often diagnosed with severe heart defects, defects in the development of the genitourinary system.

The dosage of preparations with folates at the stage of preparation for pregnancy for future parents will be selected by the doctor after the examination.

Why you need to take folic acid during pregnancy:

participates in the formation of the placenta;
is a building material for the vascular network of the placenta;
prevents miscarriage;
reduces the risk of preterm birth, complications of the gestational period.

Important! Vitamin B9 deficiency is one of the main causes of abnormal formation of the neural tube, the development of congenital pathologies in the fetus. Therefore, it is important to start drinking folic acid when planning a pregnancy in order to maintain a constant concentration of the substance in the body.

Norm and dosage

Artificial workers and children under 3 years old should be given 70 mcg per day, at 4-6 years old - 0.1 mg. Then every three years you need to increase the dosage by 0.05 mg, by the age of 16 the daily dosage is 0.3 mg.

Dosages for adults:

	Recommended daily dose (mcg)
The norm of folic acid when planning pregnancy	400
During pregnancy	460-800
Pathological course of pregnancy, megaloblastic anemia, malabsorption syndrome, gastrointestinal diseases	From 1500
lactation period	500
Men at the stage of preparation for conception	400
Elderly people	400

Why do men need

Folic acid for conception is also necessary for men so that a woman can become pregnant, endure and give birth to a healthy child.

Benefits of folate for men:

improve the production of viable sperm, increase their activity;
maintain the volume and quality of ejaculate;
reduce the risk of male infertility;
have a beneficial effect on the work of the nervous, immune, digestive systems.

Important! Folates reduce the likelihood of mutations in male germ cells. This reduces the risk of fertilization of the egg by a sperm with defects, the development of genetic abnormalities in the fetus.

What is dangerous deficiency

If the process of formation of the neural tube is disturbed, the fetus develops defects that are incompatible with life:

anencephaly - complete or partial absence of the cerebral hemispheres, bones of the cranial vault, soft tissues;
splitting of the spinal column;
violation of the process of formation and development of various internal organs;
intrauterine fetal death.

Even if there are no congenital pathologies, with a lack of folate during pregnancy, children experience a delay in growth and development.

With a deficiency of vitamin B9, women develop folate deficiency anemia caused by impaired hematopoiesis in the bone marrow. Signs - pallor, weakness, lowering blood pressure, tachycardia, unstable stool, enlarged spleen.

Other consequences:

depression;
disruption of the gastrointestinal tract, dyspeptic disorders;
deterioration in the condition of hair, nails;
infertility, early miscarriages, placental abruption, premature birth, stillbirth.

A man, against the background of a deficiency, has problems with spermatogenesis, the number of viable spermatozoa decreases, and infertility develops.

Vitamin B9 deficiency in men increases the risk of prostate and testicular cancer. Contact our doctors - at a remote consultation they will tell you about the pathologies in more detail.

Why there is a shortage

Acute folate deficiency is rare, the substance is produced in the body in the required amount. But this is subject to the normal functioning of the digestive system.

Vitamin B9 deficiency occurs in various pathological conditions in the body and an unhealthy lifestyle:

anemia;
diseases in which the process of absorption of nutrients in the intestine is disrupted;
oncological pathologies;
long-term use of combined oral contraceptives;
bad habits, abuse of caffeinated drinks.

But adults planning to conceive should not take the beneficial substance in high dosages. With an excess of vitamin B9, bloating, a bitter taste in the mouth, nausea, and loss of appetite are disturbing. In rare cases, severe allergic reactions, fever, bronchospasm are observed.

Pay attention! Folate deficiency often occurs with strict diets, constant consumption of food after heat treatment.

Artificial or natural folates?

To replenish vitamin B9, you can take special complexes or products.

Folic acid foods:

Product	Vitamin B9 content (mg/100 g)
beef liver	238
Cod liver	110
leafy greens	80
walnuts	78
Hazelnut	68
Millet porridge, mushrooms	40
Cottage cheese, cheese	35
Buckwheat	32

Important! Synthetic folates have greater bioavailability. When taking vitamin B9with food, 1 microgram is equivalent to 0.6 micrograms of synthetic folic acid. After heat treatment, the amount of folic acid is reduced by 90%, so gentle cooking methods must be used.

Reception features

How to take folic acid during pregnancy, in what dosage, only the doctor decides. Independently, focusing on the reviews, you can not prescribe vitamins for yourself.

Folate intake - things to remember:

If your doctor has prescribed prenatal vitamins with folate, you do not need to take additional folic acid.
Vitamin B9 should not be taken simultaneously with anticonvulsants, painkillers, antimalarial drugs, antibiotics and cytostatics, vitamin B12.
Take folic acid every day, preferably at the same time.
Do not change the dosage yourself, follow the instructions for use.
When prescribing folates, it is imperative to warn the doctor about the presence of chronic diseases, the features of therapy.
Ascorbic acid promotes better absorption of vitamin B9.

Folacin is poorly or not absorbed at all when taken on an empty stomach, with smoking and alcoholism. Stress, lack of sleep, and overwork negatively affect the absorption process.

At the stage of pregnancy planning, you need to start taking folic acid 3-4, sometimes 6 months before conception. Usually the drug should be taken before childbirth and after the birth of the child.

Important! Folic acid should not be taken for allergic reactions, elevated estrogen levels, asthma, malignant tumors.

FAQ

How to recognize a folic acid deficiency?

Folic acid deficiency negatively affects cognitive functions, mood. Vitamin B9 is required to prevent nervous system dysfunction at any age. Memory problems, irritability, lack of concentration, and irritability are common consequences of folate deficiency. Nausea and pain in the abdomen are disturbing, painful sores form in the mouth, the work of the heart and blood vessels is disrupted. Women have menstrual irregularities, men have problems with potency.

Can you get the right amount of folic acid from foods?

If there are no gastrointestinal diseases, other pathologies in which the absorption of vitamin B9 is disrupted, a sufficient amount of folic acid can be obtained from foods. These are offal of poultry, liver, chickpeas, spinach, asparagus, broccoli. Folic acid is found in avocados, oranges, sunflower seeds.

Why is folic acid prescribed during pregnancy?

For the development and growth of the fetus, new cells are needed, the formation of which is impossible without vitamin B9. Therefore, during pregnancy, folic acid deficiency often occurs, to eliminate which special preparations are prescribed. The main consequence of the lack of this element during pregnancy is neural tube defects. Pathologies often lead to intrauterine death of the fetus.

Expert opinion:

Folic acid is one of the important elements at the stage of conception planning, during pregnancy. With a deficiency, pathologies of the neural tube of the fetus and other pathologies in the newborn occur. To avoid problems, both parents need to take folic acid 3-4 months before the planned pregnancy.

We publish only verified information

Article author

Menshikova Maria Viktorovna obstetrician-gynecologist

Experience 38 years

Consultations 1816

Articles 46

Specialist with extensive practical experience. He has a certificate of a mammologist, a certificate of professional certification. Participates in foreign business trips and individual training programs (Los Angeles).

1982 - 1986 NPO MONIIAG - obstetrician-gynecologist
1987 - 1989 VNITs OZMIR - obstetrician-gynecologist
1989 - 1992 departmental polyclinic st. Moscow - Kurskaya - obstetrician-gynecologist
1992 - 2001 NPO MONIIAG - obstetrician-gynecologist
2007 - 2008 NP KMIKM - doctor administrator
2009 - 2013 Pereslavl Central District Hospital, women's consultation - obstetrician-gynecologist
2020 to present Teledoctor24 LLC - doctor - consultant (gynecologist)

Folic acid for pregnancy planning

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home » About clinic » Folic acid when planning pregnancy

Any woman who plans to soon become pregnant and become a mother should consciously and carefully prepare for this new status. And if everyone knows about a healthy lifestyle, parting with bad habits and walking in the fresh air, then expectant mothers often ignore the intake of certain vitamins and medicines before pregnancy. One such remedy is folic acid.

What is folic acid?

Folic acid is vitamin B9. Often you can hear the generalized name - folates, they are derivatives of this vitamin. We must understand that we get them from food, and folic acid tablets are a synthetic agent that is already converted into folates inside the body.

All derivatives of vitamin B9 play an important role in hematopoiesis, that is, the formation of new blood cells. Therefore, the lack of these substances leads to anemia - a condition in which there are not enough red blood cells, or they are irregular in shape and do not perform their functions. Folates have another very important feature: they stimulate the formation of nucleic acids (DNA and RNA), which are the basis of all body cells. Therefore, it is folic acid that is necessary for all rapidly dividing human tissues, including embryonic tissues.

The role of folic acid:

is involved in the formation of DNA in all cells, that is, the source of hereditary information;
stimulates hematopoiesis;
indirectly blocks the formation of cancer cells;
restores muscle tissue;
during pregnancy: plays a role in the formation and development of the nervous tissue of the fetus, participates in the formation of placental vessels.

Why do you need folate during pregnancy?

During pregnancy, especially in the early stages, the consumption of folate increases dramatically. All cells of the embryo are intensively dividing in order to eventually form full-fledged tissues. The nervous tissue of the future man is transformed especially quickly and difficultly. And it is she who requires a large amount of folic acid.

Folic acid deficiency during pregnancy can occur due to the following reasons:

Insufficient intake of folate from food.
Folate malabsorption (in chronic inflammatory diseases of the stomach and intestines).
Genetic disorders of the folate cycle. In rare cases, a woman's body lacks the necessary enzymes (MTHFR). As a result, folic acid is not converted to folates, and they do not perform the necessary functions. Intermediate metabolic products accumulate in the body, which can lead to cardiovascular diseases, tumor processes, infertility and miscarriage. In the presence of such a mutation, it is recommended to take folic acid derivatives, for example, Metafolin. It is absorbed faster and in greater volume.
Certain anti-epilepsy and hormonal drugs dramatically lower blood folate levels:

oral contraceptives;
barbiturates, diphenylhydantoin;
sulfa drugs (for example, biseptol), which inhibit the synthesis of vitamin B9 by intestinal microflora;
drinking alcohol also lowers their levels.

At what stage of pregnancy should I take folic acid supplements?

Folic acid intake to prevent fetal malformations should be started already at the stage of preparation for pregnancy, at least three months before the intended conception. That is why pregnancy should be planned. If conception occurred unexpectedly, then you need to start taking the drug as soon as it became known.

Reasons for taking folates at the stage of pregnancy planning:

If a woman has an unbalanced diet, her folic acid level can be low, so it takes time to replenish her reserves. It usually takes three to four months.
The neural tube of the fetus is laid at such an early stage that a woman may not even be aware of the pregnancy, especially with a long menstrual cycle.
Folate deficiency can make pregnancy difficult.

Doctors at the Intime Family Planning Clinic give the following recommendations for taking folic acid: in most cases, three months before conception and throughout pregnancy, you need to take 400 micrograms of folic acid per day. In some cases, the dosage is advised to increase: up to 1 mg per day for epilepsy and diabetes; up to 4 mg per day if there have been children with neural tube defects in the past Increased doses of folates can only be prescribed by a doctor after a thorough examination. The dose of folic acid during pregnancy remains the same.

We wish you an easy pregnancy and healthy babies!

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