Early Folate Supplementation During Pregnancy to Prevent Birth Defects

While we know that eating well is always important for optimal health, during pregnancy it is vital. It takes a lot of vitamins and minerals to make a new little human being. Everything, from the perfectly formed toes to the central nervous system, is affected by what a pregnant woman consumes. A mother-to-be must be prepared to meet the increased nutritional demands of the baby growing inside of her.

Unfortunately, with today’s busy lifestyles, many women simply aren’t getting the vitamins and minerals that they need on an everyday basis, let alone enough key nutrients to meet the extra demands of a growing baby.

Prenatal vitamins that feature these key nutrients have become a standard pregnancy protocol. They help to fill a significant nutritional gap when it is needed most. While prenatal vitamins contain a select variety of important ingredients, one nutrient stands out for its role in the creation of the body’s command center: folate.

Folate is considered one of the 13 essential vitamins. It cannot be synthesized by the body and can only be obtained from diet or supplementation. Without adequate levels, the spinal cord cannot develop properly, and sensory information is unable to travel to and from the brain.

In the very early stages of pregnancy, when a woman may not even know that she has conceived, this essential nutrient is playing a vital role in baby’s future.

Consuming adequate quantities of folate early in the pregnancy, and at least one month before conception, has been proven to help prevent neural tube defects (NTDs) like spina bifida 1 and anencephaly 2. Early and adequate consumption of this all-important vitamin is essential as neural tube defects of the brain, spine and spinal cord happen in the first month of pregnancy.

Mom Benefits Too

And, it is not just baby that benefits. A study of 10,041 pregnant women found that higher dietary folate intake, combined with supplementation, significantly decreases the risk of preclampsia, a potentially life-threatening condition that can occur during pregnancy and childbirth 3.

Folate or Folic Acid?

The terms folate and folic acid are often used interchangeably, however, there is a difference. While folate is a naturally occurring essential nutrient, folic acid, is a synthetic form of folate.

Recommended daily allowances (RDA) of folate jump from a pre-pregnancy RDA of 400 mcg to between 600 mcg and 1000 mcg when women are pregnant or attempting to conceive. This level can be extremely difficult to reach for many women from diet alone. Supplementation with a quality prenatal vitamin, helps to ensure that optimum levels are being met.

The Centers for Disease Control and Prevention (CDC) recommend that “all women between 15 and 45 years of age should consume folic acid daily…”. They estimate that most birth defects could be prevented if women consumed a recommended dose of 400 micrograms (mcg) of folic acid.3 The US Preventive Services Task Force recommends 400mg to 800 mg 5. An article on the Livestrong website states that many women opt to consume 800 to 10000 mcg a day throughout their childbearing years to ensure that optimal levels of this nutrient are met.

A study from a November 1989 issue of JAMA substantiates what the CDC promotes. It revealed that women who took multivitamins containing folic acid during the first 6 weeks of their pregnancy had substantially fewer babies with neural defects. Women in the study who, either did not take vitamins before or after becoming pregnant, or, only took multi-vitamins prior to conception, experienced a significantly higher number of infants with neural defects.2.

The same study found that women who took multivitamins without folic acid during the first 6 weeks of their pregnancy, or, began taking vitamins containing folic acid after 7 weeks of pregnancy, had results very similar to those who did not supplement.2.

Prenatal vitamins are not meant to totally replace, but rather supplement, a diet that includes folate-rich foods like spinach, avocados and asparagus. The clinical evidence supporting the value of supplementing to reach optimal levels is too strong to deny. Why take a risk?

Unfortunately, the ones most affected by the decision to supplement to meet optimal levels of folate during pregnancy don’t get a say.

The references and information on this website are intended to provide general information to the reader. The content of this post is not intended to diagnose health problems, offer personal medical advice, or for treatment purposes. It is not a substitute for medical care provided by a licensed and qualified healthcare professional. Please consult your healthcare practitioner for any advice on natural health care products or medication. No information on this website should be used to diagnose, treat, cure, or prevent a disease or condition.

1. Prue CE, Hamner HC, Flores AL. Effects of folic acid awareness on knowledge and consumption for the prevention of birth defects among Hispanic women in several U.S. Communities. J Womens Health (Larchmt ) 2010 April;19(4):689-98.

2. Glidewell J, Reefhuis J, Rasmussen SA, et al. Factors affecting maternal participation in the genetic component of the National Birth Defects Prevention Study -United States, 1997-2007. Genetics in medicine: official journal of the American College of Medical Genetics. 2014, 16(4):329-337. Doi:10.1038/gim.2013.143

3. Ray JG, Laskin CA. Folic acid and homocyst(e)ine metabolic defects and the risk of placental abruption, pre-eclampsia and spontaneous pregnancy loss: A systematic review. Placenta. 1999;20:519–529.

4. Bower C, Stanley FJ. Dietary folate as a risk factor for neural-tube defects: evidence from a case-control study in Western Australia. Med J Aust 1989;150:613-9.

5. US Preventive Services Task Force. Folic acid for the prevention of neural tube defects: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;150(9):626-631.

6. Aubrey Milunsky, Hershel Jick, Susan S. Jick, Carol L. Bruell, Dean S. MacLaughlin, Kenneth J. Rothman, Walter Willett. Multivitamin/Folic Acid Supplementation in Early Pregnancy Reduces the Prevalence of Neural Tube Defects. JAMA. 1989;262(20):2847–2852. doi:10.1001/jama.1989.03430200091032

7. Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group, authors. Lancet. 1991;338:131–137. [PubMed]