Preventing Birth Defects With Folic Acid

Folic Acid and Neural-tube Defects

By getting enough of the B vitamin folic acid in the month before she conceives and during the first several weeks of her pregnancy, a woman can help prevent a group of birth defects in her child known collectively as neural-tube defects (or NTDs). In NTDs, the central nervous system (the brain and spinal cord) and/or its coverings do not finish developing properly. Often, a portion of the brain or spinal cord is left undeveloped or dangerously exposed.

In the NTD anencephaly, the brain is severely underdeveloped. In spina bifida, part of the spinal cord is exposed or defective. Spina bifida is currently the number one disabling birth defect. The hope is that with the knowledge of the folic-acid connection, many future tragedies of this type can be prevented.

NTDs are the only birth defects to be so directly linked to the mother's nutritional status. But, in an ironic twist, traditional prenatal care may not prevent NTDs; often, by the time a pregnant woman visits her physician and begins taking prenatal supplements that provide folic acid, it is already too late to prevent an NTD. That's because all NTDs occur in the first four weeks after conception. After that, spinal-cord development is complete.

Most women, however, don't even know they're pregnant until at least three weeks after conception, and many don't seek medical care for days or weeks after that. So, it's clear: Any woman who might become pregnant (close to half of all pregnancies are unplanned) should get plenty of folic acid through her diet and/or supplementation. Indeed, the U.S. Public Health Service now recommends that any woman capable of becoming pregnant consume 0.4 milligram (400 micrograms) of folic acid a day.

Besides multivitamins or prenatal vitamins, food sources of folic acid include fortified breads, cereals, rice, pasta, and other grain foods. The Food and Drug Administration (FDA) now mandates that manufacturers add folic acid to enriched grain products (breads, flour, cereals, crackers, cornmeal, rice, pasta), just as they add other B vitamins and iron. Some breakfast cereals are fortified with the full 400 micrograms of folic acid per serving. (Check the labels on grain products to ensure the products you choose are providing you with enough folic acid every day.)

One important point to note: Folate is actually the naturally occurring form of this B vitamin; folic acid is the synthetic form found in supplements and fortified foods. Folic acid is more easily absorbed by the body. Folic acid is also the form of the vitamin that studies have linked to decreased risk of NTDs.

On the other hand, since your body requires this B vitamin (in either form) for proper protein metabolism, for cell division, and to make the red blood cells that carry life-giving oxygen throughout your body, it's still important for men, women, and children who do not take vitamin supplements to get plenty of naturally occurring folate from their diet. Good food sources of folate include leafy green vegetables (such as romaine and endive lettuce and mustard greens), broccoli, legumes (dried beans and peas and lentils), and orange juice.

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