You've probably heard of folic acid, it's a vitamin that's mentioned frequently in the media, but do you know what it is, how it works and why we're advised to take 400 micrograms daily during conception and pregnancy?
Folic acid is a B vitamin which has an absolutely vital job; it makes our DNA! Without folic acid, or folate as it's also known, cell division simply couldn't happen, and none of us would be here. Folic acid also manages and utilises protein levels in the body, and keeps our red blood cells fit, healthy and functioning properly.
As folic acid is responsible for our genetic make up, it must be important during pregnancy, right? Wrong. It's not important, it's essential! Women of childbearing age are advised to take supplements even before pregnancy, and continue until the start of the second trimester (although there's no harm in continuing throughout the entire gestation period). Folic acid is also found in some cereals, breads and margarines which have been fortified, and occur naturally in pulses, leafy green vegetables, brown rice and fruits.
Folic Acid Before Conception
If you're actively trying for a baby, it's important that you start taking folic acid supplements. It's also advised that women who could become pregnant, even if not trying to conceive, should take supplements.
Research has shown that women who take folic acid regularly before conception have a lower chance of having a baby with a cleft lip or cleft palate. A 1995 study in the United States concluded that "women who used multivitamins containing folic acid periconceptionally had a 25-50% reduction in risk for offspring with orofacial clefts compared to women who did not use such vitamins". A further study in 2007 found that taking folic acid supplements from 1 month before conception to two months after could reduce oral clefts by up to one third.
Facial clefts are splits in the upper lip or roof of the mouth and are one of the most common birth defects, with one in every 700 babies being born with a cleft lip or palate. While surgery is very effective at correcting the defect, speech, hearing and feeding problems are likely.
Folic Acid During Pregnancy
Folic acid is even more important during pregnancy, especially throughout the first 12 weeks when the brain and nerve system are in the crucial developmental stages. One of the most well known effects of folic acid is the reduced risk of spina bifida; a condition that causes problems with the spine and central nervous system. It's a life threatening disease which sees many patients suffering with lower paralysis and disabilities due to excess fluid on the brain.
Many studies have confirmed findings that an increase in folic acid reduces neural tube defects such as spina bifida, including the 1989 Multivitamin/Folic Acid Supplementation in Early Pregnancy Reduces the Prevalence of Neural Tube Defects which found that the prevalence of the disease among babies born to women who either didn't take folic acid supplements, or took them before conception only was 3.5 in 1000, which decreased significantly to 0.9 in 1000 when women continued to take supplements until at least 6 weeks of pregnancy.
Recent research is finding even more reasons for the use of antenatal folic acid supplements, such as a 38% reduction in the risk of autism and healthier birth weights.
Benefits For Mom
It's not all about Baby - there's plenty of noted advantages for Mom, too! Multivitamins have long been known to be beneficial, but folic acid in particular has some specific good points. As well as possibly cutting heart disease and stroke risks in the general population by maintaining the health of red blood cells, pregnant women may be subjected to lower instances of gestational hypertension.
Gestational hypertension is a sciencey term for high blood pressure during pregnancy. While many people may have slightly raised blood pressure which isn't normally problematic, a small increase during pregnancy can have huge consequences. Preeclampsia is one such consequence, which can cause low birth weights, premature births and can be life threatening for both Mom and baby.
While folic acid supplements before and during pregnancy are recommended, and for good reason as we've discussed above, there are some considerations that you may wish to take into account.
Much research has found a positive link between high folic acid levels and multiple births. A 2004 study published in the American Journal of Obstetrics and Gynecology concluded that "both pre- and postconceptional supplementation of a high dose of folic acid and multivitamins are associated with a slight increase of the incidence of twin pregnancies".
Furthermore, some research suggests a link between folic acid and childhood asthma, including the 2008 Folic acid supplements in pregnancy and early childhood respiratory health which found that "folic acid supplements in pregnancy were associated with a slightly increased risk of wheeze and lower respiratory tract infections up to 18 months of age".
However, it's worth noting that the researchers were keen to point out that there were only very slight increases, and the benefits of folic acid supplements far outweigh any negatives.