Folic acid is an essential supplement that women who are pregnant or intend to get pregnant need. While folic acid is a synthetic form of vitamin B9 and is available in dietary supplements and fortified foods, folate is the form of vitamin B9 found in natural foods. A deficiency of folate or folic acid during pregnancy increases the chances of neural tube defects in the growing foetus.
Experts point out that women of reproductive age require a minimum of 400 micrograms (mcg) of folic acid a day. “The folate-rich natural foods alone cannot fulfil the required amount; hence supplements are a must for pregnant women,” says Dr Sreeja Rani V R, obstetrician and gynecologist, Kinder Women’s Hospital and Fertility Center, Bengaluru.
“Neural tube is one of the earliest developing features of the fetus. This tube is responsible for the formation of the brain and spine. Healthy serum folic acid levels in the early stages of pregnancy help form the neural tube and prevent chances of defects in the spine [spina bifida] and brain [anencephaly],” says Dr Sudeshna Ray, consultant gynecologist, Jaslok Hospital and Research Centre, Mumbai.
The impact of low folic acid levels
When Tarini Mathur, a finance consultant from Vashi, Mumbai, conceived at 34, she did not assess her folate, sugar or anemia. In the 13th week of pregnancy, prenatal ultrasound imaging indicated defects in the spine of the unborn foetus. So, she had to terminate her pregnancy.
Dr Ray explains that age, diabetes, anemia and other underlying conditions increase the chances of foetal birth defects. In Mathur’s case, the serum folic acid levels were low (20 mcg). She needed folic acid supplements along with an intake of natural folate for at least three months before conception.
Who must take folic acid?
Experts say that the following women must take folic acid supplements along with natural folate:
- Women in their reproductive age who want to conceive.
- Women in the first trimester of pregnancy.
- Women who have folate-deficiency anemia (anemia or reduced red blood cells in the body due to the lack of folate).
How much folic acid is healthy?
According to Dr Rani, the prescribed amount of folic acid varies for each woman based on the underlying conditions. She further adds:
- Women of reproductive age, without any comorbid conditions planning to conceive are advised to take 400 mcg of folic acid each day.
- Pregnant women in the first trimester of pregnancy are advised 400 mcg of folic acid each day.
- Women with comorbid conditions planning to conceive (history of conception or delivery with neural tube defects or miscarriage, diabetes, obesity, epilepsy, anemia, thalassemia) are advised 5000 mcg of folic acid each day.
Natural sources of folate
Experts recommend women must consume folic acid supplements along with food rich in folate at least three months before conception.
Dr Rani emphasises that a healthy consumption of food rich in folate can also help balance folate levels.
Test the folic acid levels
Women who have comorbid conditions must plan their pregnancy. “Testing serum folic acid levels is recommended,” says Dr Rani.
Dr Ray recalls that Mathur tried to conceive after a year of her abortion. This time, she consumed folic acid supplements three months before conception along with eating a folate-rich diet. She gave birth to a healthy girl through a natural delivery.
- Folic acid is a synthetic form of vitamin B9. Folate is the natural form.
- Folic acid supplements as well as a folate-rich diet are recommended for pregnant women.
- Adequate folate levels reduce the chances of neural tube defects.
- Intake of folic acid supplements is ideal three months before conception and during the first trimester of pregnancy.