Importance of Folic Acid Supplementation in Pregnancy

Folic acid is the pregnancy superhero. Pregnant women are advised to eat balanced diets, including lots of fruit, vegetables, whole grains, and lean protein because good nutrition is vital in pregnancy.

Many women know the benefits of taking daily prenatal vitamins but may not know that folic acid is the most vital component in this wonder pill.

Folic acid is among the B vitamins essential for the baby’s healthy growth and development in the first trimester. It prevents severe congenital anomalies known as neural tube defects, which affect the baby’s brain and spine at birth.

This blog post will teach us the importance of folic acid supplementation in pregnancy, and the quantity to take, among others. Let’s dive in!

Image source: Times of India

What is folic acid?

Every cell in your body requires folic acid for proper growth and development. Folic acid, also known as folate in dietary form, can help safeguard your child from neural tube defects (NTD) if you take it before pregnancy and throughout the first trimester.

The parts of a baby that develops into the brain and spinal cord are called the neural tube. NTDs occur in the first month of pregnancy, when you may not even know you are pregnant. This is why consuming adequate folic acid before becoming pregnant is crucial.

In the US, NTDs affect about 3,000 pregnancies annually. It may be possible to prevent up to 70% NTDs if all women take 400 micrograms (mcg) of folic acid daily before taking in and during the first trimester.

Every woman of childbearing age should take folic acid every day because over half of the pregnancies in the US are unplanned.

According to research, folic acid helps prevent cleft lip and palate, a birth abnormality that affects a baby’s mouth. If a baby is born with a defect, their upper lip does not fully develop and, as a result, has an opening.

Why is taking folic acid during pregnancy important?

The embryonic neural tube, which plays a crucial role in developing the baby’s brain and spinal cord, goes through a complicated series of developmental processes during the first few weeks of pregnancy.

Folic acid is a crucial part of this complex process. The reason folic acid has a significant effect on preventing neural tube abnormalities is unclear. However, experts know that it’s crucial for DNA formation. Folic acid thus contributes immensely to tissue creation, cell growth, and development.

Getting enough folic acid through food or supplements reduces the occurrence of neural tube defects like spina bifida.

Folic acid also helps develop a baby’s heart and circulatory system. And taking the recommended dose early during pregnancy minimizes the risk of congenital heart abnormalities, the most prevalent kind of birth defect.

This magic pill is water-soluble, so your body cannot keep an excessive amount of it. Instead, it is eliminated through your urine; thus, you should routinely include adequate folic acid in your diet to prevent any deficiency while pregnant.

It’s important to have sufficient folic acid early in pregnancy because most birth abnormalities manifest within the first few weeks.

What other benefits does folic acid have?

Folic acid provides numerous benefits for both you and your unborn baby. They include the following:

a. Reducing the risk of miscarriage

A folic acid deficiency in the body might make it challenging for some women to become pregnant or maintain their pregnancy.

The importance of folic acid supplementation in pregnancy cannot be overemphasized. That is why women should take folic acid before and after conception.

b. Prevents the development of neural tube defects (NTDs) in babies

NTDs such as Spina bifida, anencephaly, and Chiari malformation, a less frequent congenital disability where the brain tissue protrudes into the spinal canal, are three neural tube birth disorders linked to insufficient folic acid intake.

But taking the correct dose of folic acid is the remedy that will ensure you have a healthy baby.

c. Protects your baby from congenital heart defects

Congenital heart defects may occur in pregnant women who do not take sufficient folic acid. These abnormalities include a hole in the heart’s wall, excessively narrow valves, improperly developed blood arteries, etc. This affects many babies each year.

d. Reduces the risk of preterm labor

So many factors can lead to preterm labor. And one of them is the lack of folic acid in the body. Taking folic acid supplements helps prevent preterm labor before 37 weeks of pregnancy.

e. Prevent your child from having a cleft lip or cleft palate

Some women who don’t take their folic acid supplements seriously may have babies with this mouth defect. A scenario in which the lip has an opening and doesn’t form properly.

f. Reduces the possibility of developing gestational diabetes

With dietary adjustments, exercise, and daily blood sugar monitoring, this pregnancy-related form of diabetes can be managed.

g. Prevents poor fetal growth

Folic acid is vital to your baby’s development and growth. Not taking folic acid puts your baby at risk of not growing or developing in the womb. Everyone wants to birth a healthy baby, and if taking daily multivitamins will bring you that, why not go for it?

i. Low birth weight

Studies have linked folic acid supplementation to birth weight. This shows that birth weight can increase due to adding folic acid to the diet before conception or during the first half of pregnancy.

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How Much Folic Acid Should You Take?

The American College of Obstetricians and Gynecologists (ACOG) advises all women actively trying to conceive or planning a family to take a daily supplement or prenatal vitamin containing at least 400 mcg of folic acid.

Discuss your nutritional requirements with your OB/GYN before trying to conceive. This is because taking folic acid before conception is necessary, as well as the importance of folic acid supplementation folic acid in pregnancy.

The recommended dose from all sources, including food and prenatal supplements, is 600 mcg. But some women need more folic acid than 400 micrograms daily before conception.

Your doctor would probably suggest you take 4,000 mcg of folic acid every day, starting three months before you become pregnant and continuing through the first 12 weeks of pregnancy if you have a high chance of giving birth to a child with a neural tube defect.

You are high risk:

  • If you previously gave birth to a baby with a neural tube defect.
  • If either you or your spouse has a neural tube defect.
  • If your spouse has a child with a neural tube defect.
  • If there is a history of neural tube defect runs in your family or that of your spouse
  • If you have diabetes
  • If you are on anti-epilepsy medication
  • If you take HIV anti-retroviral medication.
  • If your body mass index (IBM) is more than 30

How Can I Get Enough Folic Acid?

Food and Drug Administration (FDA) requires manufacturers to include folic acid in their enriched grain products. You can increase your intake by consuming breakfast cereals, pasta, bread, and rice that contain the 100% daily recommended dosage of folic acid. This information is usually on the label of the product.

But more than just folate is required as it will not give you the required 400 mcg daily dosage. You’ll require a vitamin supplement to meet the suggested daily dosage. You need more of each vital vitamin during pregnancy than you did previously.

Prenatal supplements shouldn’t replace a healthy diet. However, taking them can provide more vitamins and minerals to your body and your unborn baby.

Some medical professionals advise taking a prenatal vitamin and a folic acid supplement. Discuss your daily folic acid intake with your doctor. They may advise over-the-counter or prescription supplements or even both.

Can dietary folate and supplementation of folic acid be combined?

Combining folic acid supplements with naturally occurring folate from food is safe. There is no such thing as consuming too much folate. However, folic acid supplements, such as those found in fortified cereals, can be consumed in excess.

A person should check their use of supplements that contain folic acid but not their daily intake of folate from food.

Folic acid is a component of several multivitamins and prenatal vitamins. If a person takes several supplements, they should check the labels on each one to be sure they aren’t taking more folic acid than 1,000 mcg per day.

According to a 2020 research on mice, the brain development of mouse offspring before birth was affected by too much and too little folic acid in the diet.

When should you start taking folic acid?

Women who want to become pregnant should start taking folic acid pills before they begin trying.

This is because neural tube defects develop early, usually before a person knows she is pregnant.

Experts advise taking folic acid supplements for anyone who can become pregnant because almost half of the pregnancies are unexpected. By doing this, the risk of neural tube defect is minimized, even during a surprise pregnancy.

The body can easily process folic acid because it is water-soluble. This is why it is recommended daily.

Taking the supplement with a meal or at a set time of day is unnecessary. But forming a habit can help you remember to take your folic acid supplement, like taking a prenatal vitamin every morning with breakfast.

According to the CDC, 400 mcg of folic acid is typically present in each pill or multivitamin. To verify this, check the supplement label.

Who shouldn’t take folic acid?

There are very few circumstances where it is advised against taking folic acid supplements.

They include the following:

  • type 2 diabetes
  • epilepsy
  • celiac disease
  • lupus
  • rheumatoid arthritis
  • inflammatory bowel disease (IBD)
  • cancer
  • B12 deficiency
  • seizures
  • those on kidney dialysis

This is because folate may interact with specific drugs used to treat these illnesses. As with any prescription or dietary supplement, seek the guidance of a healthcare professional to make an informed decision.

Can folic acid affect fertility?

Image source: mybabymanual

The possibility of becoming and remaining pregnant may be increased by folic acid. In a study conducted in 2016 with over 4,000 women, the use of folic acid was compared to those who didn’t use folic acid.

The supplement users had a higher chance of becoming pregnant. There was an even stronger correlation between folic acid and getting pregnant among those whose periods were irregular, extremely short, or long.

Do folic acid supplements have any substitutes?

Some evidence supports the potential advantages of taking supplements, including L-5-Methyltetrahydrofolate, the active form of folate or folic acid.

This might be a good alternative for those taking medications that interact with conventional folate or those with MTHFR polymorphism.

What are the side effects of folic acid?

There is broad agreement among medical practitioners that taking too much folic acid has no significant adverse effects.

The idea is that because folic acid is water soluble, any excess will naturally flow through the urine. However, people have occasionally reported having an upset stomach.

Some studies, nevertheless, counter this theory. Despite contradicting findings, having too much unmetabolized folic acid in the blood may, in certain situations, increase the risk of developing certain cancers and illnesses, including anemia or insulin resistance.

Things you should look out for when buying multivitamins with folic acid

When choosing vitamins, look for “USP” or “NSF” on the package. These seals of approval signify that the tablets are properly manufactured and contain the levels of vitamins specified on the label.

Ensure the medicine has not expired, and only buy if it expires. You can seek the help of your pharmacist when choosing a folic acid or vitamin or folic.

You probably take the recommended dosage if you take daily prenatal vitamins while pregnant. But make sure you read the label.


The importance of folic acid supplementation in pregnancy cannot be overlooked. It ensures women give birth to healthy babies.

Women are advised to take the required folic acid dosage daily. Those trying to conceive should take folic acid supplements and continue even after conception, as unplanned pregnancies happen.

And if it does, you will have sufficient folic acid in your body to avoid any risk of having babies with neural tube defects.

Uchechukwu Ufoh Kyrian

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