28 Mar Pregnancy and folic acid
Do I need a folate supplement in pregnancy?
Pregnancy is one of the most important periods in a woman’s life. During this time, both energy needs as well as requirements on vitamins, minerals and micronutrients are increased. An unbalanced and nutritionally poor diet can have mild to severe effects on both the mother and the fetus.
Folate or folic acid is a vitamin B essential to the erythropoiesis process, which is increased during pregnancy, since extra blood is produced to create and develop the fetus and the placenta.
Folic acid is thought to reduce the risk of complications in pregnancy, premature labor and infant birth with reduced weight, while preventing the occurrence of congenital abnormalities of the heart and the nerve tube, such as spina bifida. A study of 5520 European women showed that the administration of 800μg of folate before conception reduced the incidence of neural tube malformations in infants.
According to the international scientific bibliography, the supplementation with folic acid is necessary and should begin 2-3 months before pregnancy and be continued throughout pregnancy and breastfeeding. More specifically, 6 months before pregnancy contraception is suggested to be discontinued, if taken, and 2-3 months before pregnancy, folic acid supplement should be taken and then, after adequate intake is ensured, women should try to get pregnant.
During pregnancy, the recommended daily intake is 600μg of which 400μg can be taken either as a supplement or from folate-enriched foods, while the remaining 200μg is taken through the diet.
Rich dietary sources of folic acid are the green leafy vegetables (suck as broccoli, spinach, greens), legumes, nuts, liver, citrus fruits and juices, and whole grain bread and egg yolk.
Folic acid supplementation is considered essential in women with insufficient dietary folic acid intake, in women who have previously had children with neural tube defects, in women who have pre-pregnancy megaloblastic anemia or develop it during pregnancy. Also, folate deficiency has greater chances of occurring in pregnant women who smoke, consume alcohol, suffer from a malabsorption syndrome, or take a medication that antagonizes folic acid. Some antiepileptic drugs (phenytoin, carbamazepine, diphenylhydantoin), medicines for malabsorption syndromes, contraceptives and some antibiotics (trimethoprim, triamterene) increase the risk of decreased levels of folic acid in the organism.
The dosage of a folate supplement should be determined by the appropriate physician and/or nutritionist, after an individualized intervention has preceded. The higher tolerated levels of folate are 800μg for pregnant teenagers aged from 14-18 years old, while pregnant women >19years old should not exceed 1000μg of folate per day. However, women who have had a child with abnormalities in the neural tube in the past may need a higher amount of folic acid than recommended.
National dietary guide for women, pregnant women and women who breastfeed, 36-48. 2014.
Academy of Nutrition and Dietetics. «Nutrition and Lifestyle for a healthy pregnancy outcome.» eat right , July 2014.
Krause’s Clinical Diet, Sylvia Escott-Stump L. Kathleen Mahan, 160-185. Medical publications Litsas , 2014.