Folic Acid and Pregnancy

How much folic acid is necessary to prevent birth defects?

(RxWiki News) Written By Anyssa Garza, PharmD, BCMAS

Folic acid can help prevent major birth defects called neural tube defects (NTDs). But how much folic acid are you supposed to get?

NTDs are major birth defects of the baby’s brain and spine that happen early in pregnancy — typically within the first month after conception.

The most common NTDs include an underdeveloped brain and an incomplete skull (called anencephaly), as well as the incomplete development of the spine and spinal cord (called spina bifida).

For more information on folic acid and birth defects, keep reading.

How Much Folic Acid Is Recommended

"To prevent NTDs, women who are planning or capable of becoming pregnant are strongly recommended to take a daily supplement containing 0.4 mg to 0.8 mg (400 mcg to 800 mcg) of folic acid each day," said Kareena Garza, MPAS, PA-C, of the practice of Lourdes Uribe, MD, Obstetrics and Gynecology.

This supplementation is recommended in addition to eating foods that contain folate. Furthermore, health experts recommend that women start taking folic acid at least one month before conception. That's because half of all pregnancies in the United States are unplanned.

"Women who have already had an NTD-affected pregnancy are recommended to take 400 mcg of folic acid each day even when not planning to become pregnant," Garza said. "Furthermore, it is recommended that they take a higher dose of folic acid (4,000 mcg) each day one month before becoming pregnant, as well as through the first three months of pregnancy."

Women who have already had an NTD-affected pregnancy and are planning to become pregnant should speak with their health care provider to discuss the best course of action.

Some women face a higher risk of having a child with an NTD. Risk factors include a personal or family history of neural tube defects, diabetes, obesity and mutations in folate-related enzymes, as well as the use of particular anti-seizure medications.

What Is Folic Acid?

Folic acid is the synthetic form of folate, which is a water-soluble B vitamin.

Folic acid is usually given as a multivitamin, prenatal vitamin or in a single supplement. In the United States, folic acid is also used to fortify cereal grain products.

Folate can be found in foods like dark green, leafy vegetables, legumes and oranges. Most women do not consume the recommended daily amount of folate from diet alone and therefore require supplementation.

You can find folic acid in the following:

  • Supplement pill form (400 mcg)
  • Multivitamin pills (An estimated 20 percent of US women now take multivitamins that typically contain 400 mcg of folic acid.)
  • Prenatal vitamins (typically containing up to 800 mcg of folic acid)

If you are concerned about your folic acid intake or the risk for NTDs, talk to your health care provider.