Folic Acid Provides Multi-Faceted Benefits During Pregnancy

One of the most profound choices a person can make is that of becoming a parent. While having a child is properly viewed as a joyous pursuit, it can also be fraught with great difficulties and unknowns. We all wish to pass on to our children every advantage we can - our genes, our health, our intellect and our morals. But health risks and genetic defects can and do occur. And even though the male and female contribute equally to the process of conception, the heavier burden is carried by the woman who is responsible for nurturing the foetus from conception to delivery.

Fortunately modern research has shed light on many aspects of conception and embryonic development. It is now known that many birth defects are genetic, allowing for screening and avoidance of such problems. Armed with the proper nutritional knowledge, women today can take steps to maximise their nutritional status and increase the odds for a healthy birth, even before attempting to conceive.

A large amount of evidence has now established that folic acid supplementation can prevent neural tube defects (such as spina bifida, anencephaly and encephalocele) in the offspring of pregnant women. Neural tube defects are a common cause of birth defects that are a significant cause of infant mortality and disability.

Although it is not fully understood how folic acid prevents neural tube defects, several theories have gained acceptance. Women who have children with neural tube defects are often found to have high levels of a toxic amino acid named homocysteine. Although originally associated with increased risk of cardiovascular disease, homocysteine also contributes to congenital heart defects, neural tube defects and vascular problems such as placental abruption, infarcts and foetal growth retardation (which can result in low birth weight).

Homocysteine is also believed to be a common cause of unexplained miscarriages in pregnant women.

Folic acid supplementation is known to reduce levels of toxic homocysteine and can thereby help to prevent homocysteine-induced birth defects and miscarriages.

A second means via which folic acid helps to prevent birth defects is by increasing the mother's production of nucleic acids (RNA and DNA) that are in strong demand during pregnancy.

Anaemia is one of the most common complications of pregnancy. It is so prevalent that it is considered a normal part of pregnancy. During pregnancy, the blood plasma volume increases more rapidly than the red cell volume. This results in the dilution of blood and causes mild anaemia. Folic acid-deficiency anaemia (known as megaloblastic anaemia) is one of the two most common forms of pregnancy-related anaemia. Supplementing with folic acid helps to prevent this type of anaemia.

It is noteworthy that the use of folic acid by pregnant women is strongly recommended and well-accepted by even the most orthodox conventional doctors. Recent studies have shown that folic acid derived from supplements is significantly better absorbed by the body compared with folic acid from dietary sources.

The Take-Home Message

Pregnant women should strongly consider using supplemental folic acid. This strategy may significantly reduce the risk of some types of birth defects (especially neural tube defects) in offspring. In addition, folic acid supplementation benefits the mother by helping to prevent one of the two most common forms of anaemia experienced during pregnancy. It also helps to prevent miscarriages during pregnancy and supports proper lactation after the new child is born. The best means of obtaining folic acid is via supplementation as folic acid supplements are better absorbed compared with dietary sources of folic acid.

The recommended dosage of supplemental folic acid for pregnant women is 400 - 800 mcg per day.

Vitamin B6 and vitamin B12 enhance folic acid's homocysteine-lowering benefits in pregnant women and are therefore desirable adjunctive supplements during pregnancy.