Folate has become a pregnancy buzzword with good reason. This simple B-group vitamin (also known as folic acid when in supplement form) continues to prove itself an essential cornerstone of good pregnancy nutrition.
What’s so good about folate? Plenty. It is essential in the formation of DNA and is found in high concentrations in umbilical cord blood, an extraction process which can leave pregnant women with folate deficiency.
Adequate folate levels have been linked with a dramatic reduction in the incidence of neural tube defects (NTD) such as spina bifida, but new roles for folate and other vitamins during pregnancy are being suggested all the time.
Why take folate?
The use of folate and multi-vitamin supplements have been linked to;
70% less risk of NTD
25-50% less risk of cleft lip and/or cleft palate
15% less risk of some urinary tract abnormalities
30% less risk of some congenital heart defects
50-70% less risk of pre-term labor
NTD
Folate is essential for development of an embryo’s neural tube, a structure which forms the brain, spinal cord and surrounding tissues and closes completely by the 3rd to 4th week of pregnancy.
The commonest NTD is spina bifida, where vertebra of the spinal column do not close, leaving a portion of the spinal cord exposed. This causes malformation of the spinal nerves and can result in deficits including lower limb paralysis and loss of bladder and bowel function. Many spina bifida children also have hydrocephalus, a build up of fluid on the brain which can result in intellectual disability. Spina bifida affects 1 in 600-700 pregnancies in Australia, and in over 90% of cases can be detected on ultrasound at 18 weeks gestation.
Other forms of NTD defect include anencephaly where large portions of the brain do not form. This condition usually results in stillbirth.
The risk of having a baby with a NTD increases when a baby’s close relative or sibling has a NTD.
When to take folate
Folate taken for 1 month prior to conception and throughout the first 3 months of pregnancy has been shown to reduce the risk of NTD by 70%. If planning a pregnancy, taking folate prior to conception is recommended as the neural tube develops completely within the first month of pregnancy, before many women realise that they are pregnant.
A recent study by the University of Texas Medical Branch in Galveston showed that folate taken for up to a year prior to conception reduced the risk of preterm labor between weeks 20-28 by 70% and by 50% in weeks 28-32.
How much?
Most studies recommend taking between 400-500 micrograms of folic acid daily. If there is a family history of NTDs or if taking medications for seizures or epilepsy, higher doses of folic acid may be required as recommended by a physician.
Natural or supplement?
Folate is the vitamin found naturally in foods, whilst folic acid is the supplement added to foods or taken in tablet form.
In 1998, the US and Canada began to fortify all flour and grains with folic acid. Other foods especially rich in folate are; asparagus, bran flakes, broccoli, chick peas, lentils, spinach and other leafy green vegetables. It can be difficult to gauge the exact folate content of foods as it can vary with cooking and storage methods.
Many women prefer the reliability of a folic acid supplement, either on its own or as part of a multi-vitamin formulation. If opting for the latter, care must be taken to ensure that only supplements meant for pregnant women are used, as regular supplements may contain doses of other vitamins such as vitamin A , which if taken in excess can harm an unborn baby.
Folate or folic acid has become an essential part of pregnancy nutrition with proven benefits for the unborn child. The power of this simple supplement to modify the development of an embryo has led to the study of other vitamins and minerals in pregnancy. The use of a pregnancy-formulated multi-vitamin supplement is a safe and simple way to enhance maternal nutrition during pregnancy leading to a healthier mother and baby.
