Spina Bifida

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Folic Acid and Pregnancy

About Folic Acid

Folic acid, sometimes called folate, is a B vitamin (B9) found mostly in leafy green vegetables like kale and spinach, orange juice, and enriched grains.

Many studies have shown that women who get 400 micrograms (0.4 milligrams) daily prior to conception and during early pregnancy reduce the risk that their baby will be born with a serious neural tube defect (a birth defect involving incomplete development of the brain and spinal cord) by up to 70%.

The most common neural tube defects are:

  • spina bifida, an incomplete closure of the spinal cord and spinal column
  • anencephaly, severe underdevelopment of the brain
  • encephalocele, when brain tissue protrudes out to the skin from an abnormal opening in the skull

All of these defects occur 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 planning to become pregnant. Only 50% of pregnancies are planned, so any woman who could become pregnant should make sure she's getting enough folic acid.

Doctors and scientists still aren't completely sure why folic acid has such a profound effect on the prevention of neural tube defects, but they do know that this vitamin is crucial in the development of DNA. As a result, folic acid plays a large role in cell growth and development, as well as tissue formation.

Getting Enough Folic Acid

The Centers for Disease Control and Prevention (CDC) recommends that all women of childbearing age — and especially those who are planning a pregnancy — consume about 400 micrograms (0.4 milligrams) of folic acid every day. Adequate folic acid intake is very important before conception and at least 3 months afterward to potentially reduce the risk of having a fetus with a neural tube defect.

So, how can you make sure you're getting enough folic acid? In 1998, the U.S. Food and Drug Administration mandated that folic acid be added to enriched grain products — so you can boost your intake by looking for breakfast cereals, breads, pastas, and rice containing 100% of the recommended daily folic acid allowance.

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 require more of all of the essential nutrients than you did before you became pregnant.

Although prenatal vitamins shouldn't replace a well-balanced diet, taking them can give your body — and, therefore, your baby — an added boost of vitamins and minerals. Some health care providers even recommend taking a folic acid supplement in addition to your regular prenatal vitamin. Talk to your doctor about your daily folic acid intake and ask whether he or she recommends 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. He or she may recommend that you increase your daily intake of folic acid (even before getting pregnant) to lower your risk of having another occurrence.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: November 2011