Why is it important to take folic acid tablets during pregnancy?

Dr Ombeva,

What is the importance of folic tabs or folic acid to an expectant woman and to the unborn child? Why do they tell us to take it during pregnancy?

Joyce

Dear Joyce,

For any woman who is pregnant or might become pregnant, you need folic acid (vitamin B9) for a number of compelling reasons. Folic acid helps prevent neural tube defects; these are serious birth defects of the spinal cord (eg spina bifida) and the brain that can occur in the baby.

Neural tube defects usually occur at a very early stage of development, in the first 12 weeks (first trimester) of pregnancy, often before many women even know they’re pregnant. Women who take the recommended daily dose of folic acid starting at least one month before conception and during the first trimester of pregnancy reduce their baby’s risk of neural tube defects by 50 to 70 percent.

Recent research suggests that folic acid may help lower your baby’s risk of other defects as well, such as cleft lip, cleft palate, and certain types of heart defects. Your body needs folic acid to make normal red blood cells and prevent anemia.

Folic acid is also essential for the production, repair, and functioning of DNA, thus getting enough folic acid is important for the rapid cell growth of the placenta and your developing baby. Research suggests that taking a multivitamin with folic acid may reduce your risk of high plod pressure in pregnancy (pre-eclampsia).

To reduce your baby’s risk of developing a neural tube defect, it is recommended that you take 400 micrograms (mcg) of folic acid per day, beginning at least a month before you start trying to get pregnant. But since more than half of the pregnancies are unplanned, it is strongly recommended that all women of childbearing age get 400 mcg of folic acid every day and at least 600 mcg daily once you’re pregnant.

The neural tube (from which your baby’s spine and brain develop) begins to form about three weeks after conception, so you must get sufficient daily dose of folic acid before conception and during the first trimester of pregnancy. Foods rich in naturally occurring folate include lentils; dried beans and peas; dark green vegetables such as broccoli, spinach, collard or turnip greens, okra, and asparagus; and citrus fruit and juice.

These foods aren’t a substitute for supplemental folic acid, but should complement your folic supplement; since, much as your body absorbs all of the folic acid in a supplement, it absorbs only some of the naturally occurring folate from the food you eat.

- Dr Ombeva Malande is a child health expert