Why is folate important in pregnancy
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.
- 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.
- 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.
- 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
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What is folate and folic acid?
Folate is a B group vitamin needed for healthy growth and development.
It is known as ‘folate’ when it is found naturally in food, such as leafy green vegetables, fruits and legumes. ‘Folic acid’ is the synthetic form of folate and is added to food, such as bread and breakfast cereals, or used in dietary supplements.
Why is folate important for pregnancy?
Folate and folic acid are important for pregnancy because they can help prevent birth defects known as neural tube defect, such as spina bifida.
Spina bifida is one of the most common birth defects. It occurs in the first weeks of pregnancy, when the brain and spinal cord are forming.
Most cases of neural tube defects can be prevented if you have enough folate before and during early pregnancy.
You can get enough folate by eating folate-rich foods and taking a supplement.
Which foods contain folate?
Many foods are naturally rich in folate, but folate dissolves in water and is easily destroyed by cooking. It is best to lightly cook vegetables or eat them raw. Microwave or steam cooking is best.
The following are good sources of natural folate:
- vegetables (broccoli, brussels sprouts, cabbage, cauliflower, English spinach, green beans, lettuce, mushrooms, parsnip, sweet corn, zucchini)
- fruit (avocado, grapefruit, oranges, berries, bananas)
- legumes (chickpeas, soya beans, lima beans, red kidney beans, lentils, haricot beans)
- eggs
- nuts
- juices (many apple and orange juices)
- Vegemite
In Australia, all flour used for making bread (except organic bread), rolls, bagels, English muffins and flat breads made with yeast must contain folic acid. It can also be found in some breakfast cereals.
Three slices of bread (100g) contains an average of 120 micrograms of folic acid.
You can check the food label of any bread product made in Australia to check if it contains folic acid (sometimes listed as folate) in the ingredients.
When should I start taking folic acid supplements?
Folic acid supplements are available in Australia over the counter from pharmacies and supermarkets, and through your doctor at varying doses.
Some women need more folate than others. Talk to your doctor about what dose of folic acid is right for you.
Generally, when trying to get pregnant or in the early months of pregnancy, you will need to look for supplements that contain at least 400 micrograms of folic acid. These will generally be supplements that contain only folic acid or special pregnancy supplements. Although many multivitamins targeted at pregnant women may contain folic acid, it’s important to check you are getting the recommended dose.
The best way to guarantee you get enough folic acid is to take a daily folic acid supplement at least 1 month before and until 3 months after conception. You don’t need to take folic acid supplements after that.
How will I know if I need a high dose of folic acid?
Some women have an increased risk of having a pregnancy affected by a neural tube defect and are advised to take a higher dose (5mg) of folic acid each day until they are 12 weeks pregnant. Women have an increased risk if:
- they or their partner have a neural tube defect
- they or their partner have a family history of neural tube defects
- they have had a previous pregnancy affected by a neural tube defect
- they have diabetes
- they have a body mass index (BMI) greater than 30
- they have a risk of not absorbing nutrients well
In addition, women who are taking anti-epileptic medication should consult their doctor for advice because they may also need to take a higher dose of folic acid.
If any of the above apply to you, talk to your doctor since they can prescribe a higher dose of folic acid. Your doctor or midwife may also recommend additional screening tests during your pregnancy.
Speak to your doctor if you are planning a pregnancy or if you think you might be pregnant.
Speak to a maternal child health nurse
Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.
Sources:
NSW Health Centre for Genetics Education (Neural tube defects fact sheet), NSW Health Centre for Genetics Education (Folate before and during pregnancy fact sheet), Australian Institute of Health and Welfare (Neural tube defects in Australia: prevalence before mandatory folic acid fortification), Food Standards Australia New Zealand (Folic acid/folate and pregnancy), NSW Health (Having a baby), Australian Journal of General Practice (Preconception care)Learn more here about the development and quality assurance of healthdirect content.
Last reviewed: June 2021
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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:
- participates 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 laying and development of the nervous tissue of the embryo, 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. - Taking certain anti-epilepsy drugs and hormonal drugs dramatically reduces blood folate levels:
- oral contraceptives;
- barbiturates, diphenylhydantoin;
- sulfa drugs (for example, biseptol), which inhibit the synthesis of vitamin B9 by the 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 of 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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what you need to know, why you need it during pregnancy
In 1931, the English physician and scientist Lucy Wheels decided to prescribe brewer's yeast extract to pregnant women with anemia. After a short time, the condition of the patients improved markedly. Scientists have long tried to understand what kind of healing component helped them.
Thanks to the improvement of technologies for extraction and isolation of substances in the form of crystals, it was possible to identify the secret component. At 19For 41 years, a team of scientists led by Professor Mitchell managed to get what they were looking for from spinach leaves.
It turned out that this is an organic acid, which was called folic acid (from the Latin folium - "leaf").
What you need to know about folic acid
Folic acid (or vitamin B9) is a water-soluble vitamin that is essential for many vital processes. Bacteria synthesize it in small amounts in the body, but most of it comes from food. These are leafy vegetables, seaweed, nuts, sunflower seeds, etc.
Among the main functions of folic acid are:
- participation in the processes of cell division during the period of active growth and development in childhood and adolescence;
- participation in DNA synthesis;
- stimulation of hematopoiesis;
- participation in metabolic processes.
Help: what are water-soluble and fat-soluble vitamins
Water-soluble vitamins are eliminated from the body naturally within a few hours. Therefore, you need to use them regularly. As for fat-soluble ones, they can be deposited, for example, in the liver.
Among these are vitamins A, E, K, D.
Benefits of folic acid for women
For women, folic acid is one of the essential components to maintain youth. Sufficient consumption of this vitamin promotes tissue regeneration, maintaining skin firmness and elasticity.
B9 is also essential for successful conception. He takes part in the maturation of female germ cells (oocytes), implantation and the formation of the placenta.
Important! Folic acid isn't just for women. Vitamin B9takes an active part in spermatogenesis - the formation of male germ cells (spermatozoa). Therefore, for successful conception, both partners need a sufficient level of its consumption. It's over 200 micrograms. per day.
Why folic acid is so important during pregnancy
Pregnant women need more vitamin B9. The World Health Organization (WHO) recommends taking at least 400 micrograms of folic acid per day during pregnancy. This is most important in the first trimester, when the organs of the future baby are laid.
For their development, it is necessary to ensure intensive cell division, which requires a large amount of folate. This is especially true of the neural tube of the fetus, from which the brain and spinal cord are then formed.
Lack of vitamin B9 in the diet can lead to serious adverse effects on the fetus, including:
- malformations of the nervous system;
- heart defects;
- increased risk of developing Down syndrome;
- vascular disorders.
Taking folic acid (and other vitamins and minerals) in the first half of pregnancy is also justified by the woman's relatively poor appetite. This happens against the background of toxicosis. Due to malnutrition, there is a shortage of biologically active substances necessary for mother and fetus.
Note that a pregnant woman needs not only folic acid, but also other B vitamins (B1, B2, B6, B12), vitamins A, D, E, C, biotin and minerals. Therefore, expectant mothers are often prescribed special complexes, for example, Elevit *, Complivit, Multi-tabs and others.
