The importance of folic acid in reducing birth defects and miscarriages

Shared from IVF Babble

Folic acid is a type of B vitamin that is recommended as a daily supplement to all women trying to conceive and throughout the first three months of pregnancy to help prevent birth defects. But experts are warning that the current recommended dose of 0.4mg of folic acid per day is ten times too low.

An expert in preventative medicine, Professor Nicholas Wald says that in order to help prevent babies being put at unnecessary risk of death and disability, women should be taking 4mg per day.

Changing the advice from 0.4mg to 4mg could save hundreds of lives a year

Professor Wald has told the i newspaper, “Taking 4 milligrams of folic acid supplements a day would have a significant effect in preventing serious birth defects and associated stillbirths, neonatal deaths, miscarriages, elective terminations of pregnancies and the physical disability from spina bifida”.

“This amount of folic acid, taken from before conception to the 12th week of pregnancy, reduces by 83 per cent the risk of the foetus developing neural tube birth defects of the brain, spine, or spinal cord that can also cause anencephaly, in which a baby is born without parts of the brain and skull and encephalocele, another very serious skull defect.”

Folic acid supplements help to top up levels of folate, or vitamin B9. Around 1,000 foetuses a year in the UK develop neural tube defects. They’re often picked up during routine screening and such is their potential severity, many women choose to have an abortion.

Professor Wald says that it’s unlikely that a woman will have naturally high enough levels of folate because “the blood levels of folate are really relatively low by any standards – this is a vitamin deficiency disorder that is endemic throughout the world, including rich countries”.

Dark green leafy vegetables such as spinach and broccoli are naturally rich in folate but it’s unlikely that we’d get enough from our diet to help protect against birth defects. “To get the levels that will provide the maximal possible protection is extremely difficult to do just by changing diet – and changing diet is pretty difficult”.

Currently, the largest single dose folic acid supplement available is 0.8mg, so Professor Wald advises taking five a day. However, even two or three would be beneficial

“A bit less will accomplish most of the protective effect. You get most from the first 0.8mgs. So you should certainly use at least one 0.8mg pill and if you want added effect you could take two, three or four additional ones.”

He advises taking these supplements whilst trying to conceive

“If you wait till you know you are pregnant before you start taking folic acid there is probably no benefit because the neural tube develops in the first few weeks of pregnancy”.

Some claim that taking such high levels of folic acid may “mask” a vitamin B12 deficiency in those with anaemia, but Professor Wald says these claims are outdated and that the government guidelines need to catch up.