5 Reasons To Take Folic Acid In Pregnancy And Its Dosage

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Neural tube defects such as anencephaly and spina bifida affect approximately one in 1,000 babies (1). Experts claim taking supplements of folic acid in pregnancy is effective in significantly lowering the risk of these congenital anomalies. Therefore, folic acid or folate is recommended for consumption before and after a woman conceives. Read this post as we discuss the importance of folic acid during pregnancy, the amount you need, its sources, and when to avoid taking it.

What Is Folic Acid?

Folic acid is a synthetic form of vitamin B9 found in fortified foods and other supplements. It is usually utilized by the body to produce new cells and nucleic acid (which is a form of genetic material). It is essential for the healthy growth and development of the baby and helps in carrying out specific functions such as producing red blood cells, protecting the child’s ability to hear and supporting the baby’s organ development (2).

Experts recommend taking 400mcg of folic acid along with prenatal vitamins every day before and during pregnancy (3).

Why Should You Take Folic Acid When Pregnant?

Here is why you need to increase your  if you are pregnant or are trying to get pregnant.

1. Prevents neural tube defects:

Folic acid helps in the neural development of the fetus. The neural tube of your fetus, which later grows into the brain and spinal cord of your baby, is protected by folic acid to prevent any prenatal defects during the early formation of the central nervous system (2).

2. Produces red blood cells:

Folate enhances the production of red blood cells in your body. This is vital during pregnancy when anemia (iron deficiency) is a common complaint. Folic acid ensures that the red blood cell (RBC) count in your body is normal even when you take other supplements that could replenish the iron (4).

3. Protects the baby from several complications:

Folic acid lowers the baby’s risk of cleft lip and palate. It also reduces the risk of premature birth, miscarriage, poor baby growth in your womb and low birth weight problems (2).

4. Protects expectant mom:

Adequate intake of folic acid everyday is known to prevent preeclampsia, heart stroke, heart disease, cancers and Alzheimer’s disease (5).

5. Other essential functions:

Folic acid is required for the production, repair, and functioning of DNA. It is also important for the quick growth of the placenta and developing baby (6).

Given its importance, folic acid needs to be taken even before you get pregnant.

When Should You Start Taking Folic Acid?

Your doctor will advise you to start taking folic acid when you plan to conceive. Considering that most birth defects could develop in the first trimester, consuming folate even before you conceive can be extremely helpful.

Consult your healthcare provider before picking your prenatal vitamins and make sure that it has the recommended amounts of folate you need.

How Much Folic Acid Do You Need?

The standard breakup of recommended folic acid consumption before, after and during pregnancy is as follows (7):

  • Before conceiving: 400mcg
  • First trimester of pregnancy: 400mcg
  • Second and third trimesters of pregnancy: 600mcg
  • Breastfeeding stage: 500mcg

Consult your doctor to understand how much folic acid you have to consume, considering your personal, past, and family history, the other supplements you are taking and vitamin deficiencies if you have any.

How Long Do You Need To Take Folic Acid During Pregnancy?

You can start taking folic acid at least three months before pregnancy and all through the pregnancy in high risk cases to lower the risk of birth defects (7).

What Are The Effects Of Folic Acid Deficiency During Pregnancy?

Deficiency of folic acid will lead to pregnancy anemia with symptoms such as decreased appetite, pale skin, lack of energy, diarrhea, headache, and irritability (8). In the case of a moderate deficiency, you may not experience any symptoms but will lack the necessary amount of folate needed for baby’s embryonic development.

Folic Acid Food Sources

Folate is found in several foods but is water-soluble and easily destroyed or eliminated when cooked. Therefore, the best way is to cook them just a little bit or eat raw if possible. Steaming or cooking by microwave is also good.

Here is a list of foods rich in folic acid (9). Folate per half cup of serving:

  • Cooked spinach: 131mcg
  • Fortified breakfast cereals: 100mcg
  • Black-eyed peas: 101mcg
  • Asparagus: 89mcg
  • White rice: 90mcg
  • Brussel sprouts: 78mcg
  • Spaghetti: 83mcg
  • Romaine lettuce: 64mcg
  • Avocado: 59mcg
  • Raw spinach: 58mcg

Some other good sources of folate are cabbage, green beans, mushrooms, sweet corn, zucchini, grapefruit, orange, legumes, juices, nuts, and eggs.

When Should You Stop Taking Folic Acid?

You can stop taking folic acid once you reach 12 weeks of pregnancy since the baby’s spine will be well developed by then. However, you can continue taking folate post the 12th week, as it will not harm you or your baby in any way (10).

Keep reading for answers to more questions about folic acid intake during pregnancy.

Frequently Asked Questions

1. Which folic acid tablets are good to take before or during pregnancy?

Some of the most commonly used folic acid supplements are from the brands such as Nature’s Blend, Now Foods and Nature’s Bounty.

2. How does folic acid help when I am trying to get pregnant?

Folic acid can improve your chances of becoming pregnant, as it boosts fertility and also improves RBC production besides providing other health benefits.

3. Are folic acid and prenatal vitamins the same?

Folic acid is already present in the prenatal vitamin formulas. If there is any need for extra folate, your doctor may prescribe additional folic acid supplements.

4. How much folic acid is required for twin pregnancy?

Women carrying twins need about 1,000mcg of folate per day (11).

5. Can folic acid intake during pregnancy cause diarrhea?

Folic acid deficiency can cause diarrhea. In such a case, make sure to have enough water to avoid dehydration and seek the doctor’s help to control diarrhea.

6. Can folic acid cause multiple pregnancies?

No, folic acid supplementation before pregnancy will not increase the likelihood of multiple pregnancies (12).

7. Is too much folic acid bad for pregnancy?

Yes, too much folic acid can increase your baby’s risk of developing autism, obesity, insulin resistance and cognitive impairment (13).

The deficiency of folic acid in pregnancy may cause anemia. And symptoms such as headache, diarrhea, or fatigue may go unnoticed in mild cases, but they may still be harmful to the fetus. Folic acid, or the synthetic form of vitamin B9, is essential during pregnancy as it helps in forming the neural tube and red blood cells. It reduces the risk of several congenital disabilities and prevents preeclampsia in pregnant women. Experts recommend that women planning a pregnancy may start taking folic acid three months before conceiving. However, one may get it prescribed by a doctor to avoid an overdose.

References:

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  1. Henk J. Blom et al.; (2006); Neural tube defects and folate: case far from closed.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2970514/
  2. James A. Greenberg et al,; (2011); Folic acid supplementation and pregnancy: more than just neural tube defect prevention.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3218540/
  3. Women need more than 300 micrograms of folic acid every day, CDC.
    https://www.cdc.gov/ncbddd/folicacid/features/folic-acid.html
  4. Folic acid, OASH, Office on Women’s health.
    https://www.womenshealth.gov/a-z-topics/folic-acid
  5. Folate, Oregon State University.
    https://lpi.oregonstate.edu/book/export/html/71
  6. Reyna Penailillo et al.; Folic Acid Supplementation during Pregnancy Induces Sex-Specific Changes in Methylation and Expression of Placental 11βHydroxysteroid Dehydrogenase 2 in Rats.
    http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.809.3845&rep=rep1&type=pdf
  7. Nutrition during pregnancy, ACOG.
    https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy
  8. Folate-Deficiency Anemia, University of Rochester Medical Center.
    https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=85&ContentID=P00089
  9. Folate (Folic acid)-Vitamin B9, Harvard.
    https://www.hsph.harvard.edu/nutritionsource/folic-acid/
  10. Breige McNulty et al.; Impact of continuing folic acid after the first trimester of pregnancy: findings of a randomized trial of Folic Acid Supplementation in the Second and Third Trimesters.
    http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.859.4530&rep=rep1&type=pdf
  11. Getting enough folic acid (folate), University of Michigan Health.
    https://www.uofmhealth.org/health-library/ue2418
  12. Tali Levy and Issac Blickstein;(2006); Does the use of folic acid increase the risk of twinning?
    https://pubmed.ncbi.nlm.nih.gov/17039857/
  13. Too much folate in pregnant women increases autism risk, study suggests, John Hopkins University.
    https://hub.jhu.edu/2016/05/12/too-much-folate-pregnant-autism/

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Dr. Shashwat Jani

(MS)
Dr. Shashwat Jani is a consultant obstetrician & gynecologist in Smt. N.H.L. Municipal Medical College, Ahmedabad. His field of interests are High Risk Pregnancy, Infertility and Endoscopy. He has written 12 chapters in reference books of Ob/Gyn and published 18 articles in Index journals. Dr. Jani has been invited as faculty in more than 200 national and international conferences. He... more

Rebecca Malachi

Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She has been into health and wellness writing since 2010. She received her graduate degree in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig... more

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