Folic acid essential for healthy developing fetus

Did you know that a daily dose of a certain B vitamin can reduce birth defects by 46 percent?¹ Folic acid helps the body make new cells. In a developing fetus, it can help prevent some major birth defects of the brain and spine by 50 percent to 70 percent.²

Everyone needs folic acid. However, women — particularly women who want to get pregnant — need at least 400 micrograms (mcg) daily to ensure proper development of a fetus. Many multivitamins contain 400 mgc of folic acid. Taking that amount of the vitamin before conception is essential for a fetus’ neural tube to develop fully. The neural tube is the initial, formative part of the spine and back. When the neural tube fails to form completely, the baby may be born without parts of the brain and skull (anencephaly) or with part of the spinal cord exposed (spina bifida).

Jan. 8-14 is National Folic Acid Awareness Week, part of National Birth Defects Prevention Month. HealthTeamWorks, along with the federal government, wants to ensure that people know the risks of insufficient folic acid intake on a developing fetus.

"Promoting protective factors, such as taking a daily multivitamin containing folic acid, eating well and exercising, and reducing risk factors such as smoking, alcohol use, obesity and poor mental health, is critical for the health of all women and any potential offspring," says Linda Archer, MSN, RN, CNS, Maternal Wellness Project specialist with the Colorado Department of Public Health and Environment.

Consuming folic acid daily before and during early pregnancy will help reduce the risk for neural tube defects. Healthcare providers should encourage every woman to consume 400 mcg of synthetic folic acid daily from fortified foods or supplements, or a combination of the two, in addition to getting folate that occurs naturally in certain foods. Good sources include: 

• Leafy green vegetables such as spinach, broccoli and lettuce;

• Okra;

• Asparagus;

• Fruits such as bananas, melons and lemons;

• Beans;

• Yeast;

• Mushrooms;

• Meat, including beef liver and kidneys; and

• Orange and tomato juice.³

In addition, since 1998, federal law has mandated that food manufacturers add folic acid to cold cereals, flour, breads, pasta, bakery items, cookies and crackers.⁴ Folic-acid fortified foods can help people increase their intake of the nutrient.

HealthTeamWorks’ clinical Guideline for Preconception and Interconception Care puts folic acid at the top of the list of factors that affect fetal health and development. Because 39 percent of pregnancies in Colorado are unplanned⁵ (50 percent nationwide⁶), and because folic acid intake is such a simple way to promote fetal health, we urge providers to counsel their female patients of child-bearing age about the importance of getting enough folic acid.

Anna Kelly, MD, who serves on the Healthy Women Healthy Babies Roundtable, participated in the committee that developed the HealthTeamWorks Guideline for Preconception and Interconception Care, says "While numerous individual preconception interventions are known to improve pregnancy outcomes, the HealthTeamWorks Preconception and Interconception Care guideline strives to summarize, simplify and prioritize interventions that have the strongest evidence. [It does so] in a manner that can serve as a foundation for provider- and consumer-focused preconception projects in Colorado and beyond."
 

Sources
1. Jan. 6, 2012, 60(51);1746. National Birth Defects Prevention Month and Folic Acid Awareness Week — January 2012. www.cdc.gov/mmwr/preview/mmwrhtml/mm6051a6.htm?s_cid=mm6051a6_e. Accessed Jan. 5, 2012.
2. Centers for Disease Control and Prevention. Facts about folic acid. www.cdc.gov/ncbddd/folicacid/about.html. Accessed Jan. 5, 2012.
3. WebMD. Folic acid. www.webmd.com/vitamins-supplements/ingredientmono-1017-FOLIC%20ACID.aspx?activeIngredientId=1017&activeIngredientName=FOLIC%20ACID. Accessed Jan. 5, 2012.
4. Ibid.
5. Colorado Department of Public Health and Environment, Health Statistics Section (2010). Colorado MCH Data Set 2010. Retrieved October 12, 2010 from www.cdphe.state.co.us/ps/mch/mchadmin/mchdatasets2010/profiles/colorado.pdf.
6. Finer LB, Henshaw SK. Disparities in Rates of Unintended Pregnancy in the United States, 1994 and 2001. Perspectives on Sexual Reproductive Health, 2006:38:90–96.