Why Take Folic Acid During Pregnancy

What Are Other Reasons For An Elevated Afp

An elevated AFP could mean the mother is carrying twins or that there is a problem with the placenta. Women with diabetes or liver disease may also have an elevated AFP level.

However, an elevated AFP could also mean that there are birth defects present such as severe kidney disease, liver disease, esophageal or intestinal blockage, Down Syndrome, urinary obstruction, or osteogenesis imperfecta .

Optimizing Dietary Folate Intake

Following a healthy eating pattern and choosing foods that are rich in nutrients helps women meet their requirement for folate and other nutrients. To promote adequate dietary folate intake:

• Encourage women to use Canada’s Food Guide. It describes a healthy eating pattern that is rich in dietary folate. Following Canada’s Food Guide will also help women meet their needs for other nutrients and can help them achieve overall health.
• Promote use of tools such as My Food Guide Servings Tracker. This can help women keep track of the amount and type of food they eat each day and compare their intake to Canada’s Food Guide.
• Encourage women to include grain products fortified with folic acid each day, such as enriched bread or enriched pastaFootnote 11. They can make informed choices, by looking for the term ‘folic acid’ in the ingredient list.
• Encourage women to have legumes, such as beans or lentils, often and eat at least one dark green vegetable, such as peas or romaine lettuce, each day.
• Refer women to a Registered Dietitian if they have a significantly restricted food intake. This can happen when women exclude an entire food group or have severe nausea or vomiting. These women can benefit from comprehensive nutritional assessment and counselling.
• Refer nutritionally at-risk women to services or programs that can help. The Canada Prenatal Nutrition ProgramFootnote 12 .Website provides contact information for programs and services for vulnerable pregnant women.

What Are The Signs Of Folic Acid Deficiency Anemia

Folic acid deficiency is rare, because so much food is fortified with folic acid, and anyone eating a balanced diet is likely to get enough. However, folate deficiency can lead to anemia, and may cause symptoms such as lack of energy, pale skin, decreased appetite, diarrhea, irritability, or a smooth, tender tongue.

You may also experience these symptoms if youâre deficient in vitamin B12 or iron, so check with your healthcare provider to be sure you know the problem you need to address.

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How Are Neural Tube Defects Diagnosed

Neural tube defects are detected through an alpha-fetoprotein test . AFP is a blood test administered at 16-18 weeks gestation. The test measures alpha-fetoprotein, a substance produced by the fetus and secreted into the amniotic fluid.AFP is also found in the mothers blood. The level of AFP in the mothers blood peaks at about 30-32 weeks. Abnormally high amounts of AFP may indicate that a baby has a neural tube defect.

How Can I Get Enough Folic Acid

How can women of childbearing age and especially those who are planning a pregnancy get enough folic acid every day?

The U.S. Food and Drug Administration requires food-makers to add folic acid to their enriched grain products. So you can boost your intake by eating breakfast cereals, breads, pastas, and rice that have 100% of the recommended daily folic acid allowance. Check the product’s label for this information.

But for most women, eating fortified foods isn’t enough. To reach the recommended daily level, you’ll probably need a vitamin supplement. During pregnancy, you need more of all of the essential nutrients than you did before you became pregnant.

Prenatal vitamins shouldn’t replace a well-balanced diet. But taking them can give your body and your baby an added boost of vitamins and minerals. Some health care providers recommend taking a folic acid supplement in addition to a prenatal vitamin. Talk to your doctor about your daily folic acid intake. He or she might recommend a prescription supplement, an over-the-counter brand, or both.

Also talk to your doctor if you’ve already had a pregnancy that was affected by a neural tube defect or if you or your partner were affected by one yourselves. The doctor may recommend that you take a higher dose of folic acid .

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What Are The Health Benefits Of Taking Folic Acid During Pregnancy

Approximately 3,000 babies are born with neural tube defects in the United States each year. Normally, the neural tube develops into the spinal cord and brain by 28 days after conception.

If the neural tube doesnt close properly, neural tube defects occur. Anencephaly is a condition in which the brain doesnt develop properly. Babies born with anencephaly cannot survive.

Babies born with spina bifida or encephalocele may face multiple surgeries, paralysis, and long-term disability.

According to a

Research also shows folic acid supplementation in early pregnancy may help prevent cleft lip and cleft palate.

These birth defects occur if parts of the mouth and lip do not merge together properly during the first 6 to 10 weeks of pregnancy. One or more surgeries are usually needed to correct the condition.

When Should I Start Taking Folic Acid In Pregnancy

If you are planning a pregnancy, it is important to take a folic acid supplement from 3 months before becoming pregnant. If you find out you are pregnant, try to start taking folic acid as soon as possible up to week 12 of pregnancy.

If you are past 12 weeks in your pregnancy and did not know you should take folic acid, try not to worry. The risk of this affecting your baby is still very small.

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When Should You Start Taking Folic Acid

Your doctor will advise you to start taking folic acid when you plan to conceive. Considering that most birth defects could develop in the first trimester, consuming folate even before you conceive can be extremely helpful.

Consult your healthcare provider before picking your prenatal vitamins and make sure that it has the recommended amounts of folate you need.

Why Is Folic Acid So Important When Trying To Conceive

Folic acid is vital for any mum-tube as it helps to lower the he risk of NTDs such as Spina Bifida, in the foetus. If the unborn spine and brain fail to form correctly,, these NTDs occur and cause unrepairable damage to the nervous system and spinal cord. Vitamin B9, more commonly known as folic acid, can help stop the complex conditions from occurring.Folic acid or folate or Vitamin B9 has many health benefits that prepare a woman for pregnancy. These include:

• Support production of new cells.
• Prevents abnormal changes in the DNA.
• Helps to correct certain types of anemia.
• Supports the nervous system health.

A woman who has a deficiency of folic acid is at risk of developing health problems and in case she gets pregnant, she will expose her unborn baby to serious health conditions. Deficiency can lead to miscarriage and if the pregnancy goes to term then disorders of the brain-spinal cord system can occur. They are collectively called Neural Tube Defects. This is a poorly developed brain-spinal cord system. The commonest types of neural-tube defects are:

A defect on the brain or the spinal column leads to other problems like paralysis and deformity of the lower limbs. There may also be disorders of bowel and bladder control. These serious defects can be prevented by taking a diet rich in folic acid or supplementing with folate tablets.

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Advising On The Upper Limits Of Folic Acid Supplementation

High doses of folic acid can hide signs of vitamin B12 deficiency. They can also bring on or accelerate neurological complications associated with B12 deficiency . As well, women who have low vitamin B12 status are at higher risk for NTD . The prevalence of vitamin B12 deficiency in women of childbearing age is considered very low . However, some studies suggest that more women in this life stage group may have low vitamin B12 status than expected . Women who do not or infrequently consume foods of animal origin and do not take a vitamin B12 containing supplement are most likely to have deficient or marginal vitamin B12 status .

Emerging data also suggest there may be additional health risks associated with taking folic acid, including the development of colon cancer when preneoplastic cells are present . It is important that health care professionals do not advise higher doses of folic acid than is recommended in this document, unless duly warranted.

How Much Folic Acid Should I Be Taking

It is not only the amount of folic acid that you take that is important, but the timing. Most neural tube defects happen in the first 4 weeks of pregnancy, often before the mother is even aware she is pregnant. Roughly half of pregnancies are unplanned, so even if you are not trying to get pregnant but are of reproductive age, consider taking a daily multivitamin containing 0.4 mg folic acid. If you are trying to conceive, folic acid supplementation differs depending on your particular risk for neural tube defects. In addition to eating a diet rich in folic acid, follow the recommendations in this table.

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What Are The Risks Of Not Taking Folic Acid

The absence of this important nutrient increases the possibility of a neural tube defect .

• Spina bifida is a condition in which the spinal cord is exposed. If the vertebrae surrounding the spinal cord do not close properly during the first 28 days after fertilization, the cord or spinal fluid bulge through, usually in the lower back.
• Anencephaly is the severe underdevelopment of the brain.

Study Cohort Characteristics And Folate Biomarkers In Mothers And Newborns

There were no significant differences between the placebo and treatment groups in general maternal or child characteristics . Pre-intervention , neither serum nor RBC folate, showed significant differences between the treatment groups, but both biomarkers were significantly higher in the FA group compared with placebo following intervention . Analysis of the cord blood at delivery also showed significantly higher folate concentrations in the FA treatment group. The frequency of the MTHFR 677TT genotype was not significantly different between the treatment groups among mothers or children.

Table 1 General characteristics of FASSTT Offspring Trial participants at age 3 and 7years

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It Helps With The Development Of Red Blood Cells

Folic acid is useful in the making of red blood cells in the human body. Folic acid collaborates with vitamin B-12 to make red blood cells and to help iron function properly in the body. This keeps the mother from developing pregnancy anemia.

The blood volume of a pregnant mother increases, thus increasing the need for more red blood cells and iron to make more blood. More blood ensures that the baby gets enough food and oxygen.

Folic acid deficiency in pregnancy inhibits the production of red blood cells, thus compromising the oxygen supply to the baby in the womb. If there arent enough red blood cells, the oxygen supply to the baby is compromised.

What Are Neural Tube Defects

Neural tube defects are birth defects that involve incomplete development of the brain and spinal cord. The most common neural tube defects are:

• spina bifida: when the spinal cord and spinal column don’t completely close
• anencephaly: a severe underdevelopment of the brain
• encephalocele: when brain tissue protrudes out to the skin through an opening in the skull

All of these defects happen during the first 28 days of pregnancy usually before a woman even knows she’s pregnant.

That’s why it’s so important for all women of childbearing age to get enough folic acid not just those who are trying to become pregnant. Half of all pregnancies are not planned, so any woman who could become pregnant should make sure she gets enough folic acid.

It’s not clear why folic acid has such a profound effect on the prevention of neural tube defects. But experts do know that it’s vital to the development of DNA. As a result, folic acid plays a large role in cell growth and development, as well as tissue formation.

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Why Do You Need Folic Acid Before Getting Pregnant

Folic acid plays a pivotal role in cell division and the replication of DNA. Early pregnancy is a time of rapid growth. This is the time when the babys brain and nervous system begin to form. Since a significant number of pregnancies are unplanned and most women have low dietary consumption, taking folic acid before pregnancy helps protect the foetus against diseases. Studies have shown that an inadequate amount of folic acid can cause neural tube defects such as spina bifida. This is a condition where the protective covering that develops around the foetus spinal cord doesnt close properly and leaves a gap. This can lead to nerve damage and paralysis in future. The recommended intake period is three months before pregnancy and the first three months afterwards. Since folic acid helps with fertility in women, it helps to start taking it a few months before a couple tries to conceive.

Where To Get Pregnancy Supplements

You can get supplements from pharmacies and supermarkets, or a GP may be able to prescribe them for you.

If you want to get your folic acid from a multivitamin tablet, make sure the tablet does not contain vitamin A .

You may be able to get free vitamins if you qualify for the Healthy Start scheme.

Find out more about the Healthy Start scheme.

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Ive Been Trying To Get Pregnant But Havent Been Taking Folic Acid Supplements Should I Stop Trying To Conceive

Ideally, you should take folic acid supplements for two to three months before you conceive and until you are 12 weeks pregnant.

But try not to worry if you havent started taking the supplements yet and start taking it now. You can talk to your GP or midwife if you have any concerns.

Think you’re ready for pregnancy? Take a look at our online pregnancy planning tool.

1. Sue Macdonald, Gail Johnson, Mayes Midwifery. , p 312.

2. NHS Choices Why do I need folic acid in pregnancy? Page last reviewed: 16/03/2016 Next review due: 16/03/2018

3. NHS Choices Spina bifida Page last reviewed: 04/05/2017 Next review due: 04/05/2020 www.nhs.uk/conditions/spina-bifida

4. NHS Choices Vitamins and minerals Page last reviewed: 03/03/2017 Next review due: 03/03/2020

Review dates

Last reviewed:Next review:

Can I Get Folate From Food

Yes. You can get a natural serving of folate from a healthy diet rich in

• dark leafy greens, such as spinach and romaine lettuce,

• broccoli,

• melons,

• strawberries.

You can also find folic acid in fortified foods like breakfast cereals, bread, white rice, and pasta. Just check the label to make sure the food has been fortified with folic acid.

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Useful For Dna Replication

The most rapid cell division in humans occurs in an egg that has been fertilized. For cells to divide, the DNA must duplicate itself to form an entirely new cell. This process of a cell making a copy of itself is what is referred to as DNA replication.

Folic acid in pregnancy is essential for this replication to happen.

About Neural Tube Defects

The neural tube is the part of the developing baby that becomes the brain and spinal cord. NTDs occur when the neural tube does not fully close during the early weeks of pregnancy.

This results in spine, brain and skull defects that can lead to stillbirth or lifelong disability. Spina bifida and anencephaly are the most common NTDs.

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What Are The Best Folic Acid Foods

Your daily prenatal vitamin is like a nutritional backup plan during pregnancy and it comes in handy especially on days when you feel too sick to eat. That said, a vitamin or supplement can’t replace a healthy diet. It’s vital to eat plenty of folate-rich foods when you’re expecting, since they’re also full of many other important baby-making nutrients like fiber, calcium, vitamin A and vitamin C.

And if youre breastfeeding, experts recommend taking a basic daily women’s multivitamin that contains 100 percent of the recommended daily value of all nutrients, including folic acid. You can either continue to take your prenatal vitamin or a supplement designed for breastfeeding moms.

Some of the best food sources of folate to incorporate into your diet include:

• Dark leafy green vegetables: 262 mcg in 1 cup cooked spinach
• Avocado: 118 mcg in 1 cup
• Legumes: 92 to 210 mcg in 1 cup
• Broccoli: 104 mcg in 1 cup chopped and cooked
• Asparagus: 178 mcg in eight cooked spears
• Oranges: 29 mcg in one fresh small orange, or 35 mcg in 3/4 cup orange juice
• Foods fortified with folic acid, including whole grain breakfast cereal, bread, pasta and rice

• What to Expect When Youre Expecting, 5th edition, Heidi Murkoff.
• James Greenberg, M.D., obstetrician and gynecologist, Brigham and Women’s Hospital, Boston, MA.