Taking Folic Acid Before Pregnancy – Why It Is Important?

Folic acid is a synthetic form of vitamin B9 which is essential for the body’s development and to ensure good health. In the first few weeks of pregnancy, it is critical to have an adequate amount of folic acid in the body for the proper development of the foetus. Deficiency of folic acid in early pregnancy is the cause of congenital birth defects which can be avoided with proper supplementation of the vitamin.


What is Folic Acid

Folic acid, which is also known as vitamin B9, is one of the B vitamins that come under the classification of Folate. They are critical compounds required for the process of production and maintenance of cells along with the synthesis of DNA and RNA. They are instrumental in preventing changes to the DNA and thus, preventing cancer. Therefore, folic acid is especially important during periods of cell division and rapid growth such as pregnancy and infancy. Folic acid is naturally found in foods such as whole grains, oranges, dark green leafy vegetables, pulses, liver, avocados, spinach, beetroot etc. The amount of folic acid from natural sources may not be enough to provide for the needs of the body. To combat this, food manufacturers often add it to some breakfast cereals and bread to meet the daily requirement. As the body cannot synthesise folic acid, its intake must be dietary. Not consuming enough of it can lead to folate deficiency which results in a type of anaemia and weakness. Long-term supplementation of folic acid has also shown benefits in reducing the risk of cardiovascular disease and stroke.


Why You Need Folic Acid Before Getting Pregnant

Folic acid plays a pivotal role in cell division and the replication of DNA. Early pregnancy (first twelve weeks) is a time of rapid growth. This is the time when the baby’s brain and nervous system begin to form. Since a significant number of pregnancies are unplanned and most women have a low dietary consumption, taking folic acid before pregnancy helps protect the foetus against diseases. Studies have shown that an inadequate amount of folic acid can cause Neural Tube Defects (NTDs) such as Spina Bifida. This is a condition where the protective covering that develops around the foetus’s spinal cord doesn’t close properly and leaves a gap. This can lead to long-term permanent nerve damage and paralysis. The recommended intake period is three months before pregnancy and the first three months afterward. Since folic acid helps fertility in women, it helps to start taking it a few months before conception.

How Much Folic Acid To Take

The recommended amount for all women who are capable of conception is 400 micrograms (mcg) of folic acid every day before the pregnancy. The supplement should also be continued 12 weeks into the pregnancy to prevent a range of NTDs. For women who have health problems such as diabetes, epilepsy, and coeliac disease, the doctor might recommend a higher dose in the range of 5 milligrams (mg) a day. At the time of pregnancy, the folic acid intake should be around 600mcg from four to nine months and 500mcg during breastfeeding.

Although the health benefits are great, there is also a downside of folic acid supplements in some women. The side effects of taking folic acid before pregnancy include children born with respiratory tract infections, asthma, and a higher rate of breast cancer in women.

Benefits Of Consuming Folic Acid

Since the dietary intake of folic acid is low in most women, supplements are the best way to guard oneself against deficiency during pregnancy. It is best to start folic acid supplements a few months prior to conception to help protect the baby.

The folate benefits before pregnancy are as follows:

  • Folic acid supplements reduce the chances of foetuses with diseases such as Spina bifida (Neural tube defect condition with malformed spine) and Anencephaly (incomplete development of the brain) by at least 50% along with lowering other congenital anomalies.
  • It shields the baby from risks of cleft lip palate, poor growth in the womb and low birth weight.
  • It lowers the risk of miscarriages and preterm delivery. The deficiency of folic acid increases homocysteine levels in the blood which lead to complications and unprompted abortions.
  • Folic acid is necessary for the health, growth, and development of the body’s cells.
  • It helps protect the DNA from damage which may result in cancer.
  • Folic acid helps in the production of red blood cells and prevent a certain type of anaemia
  • It is useful in the production and functioning of the genetic map and the basic building blocks of the body’s cells.
  • Folic acid is also vital in helping the rapid cell growth in the placenta of the baby.

Folic Acid Foods

Since folic acid is a synthetically produced supplementary product, it is advisable to obtain some fraction of the total daily requirement of folates from natural dietary sources.

Here are 15 folate rich foods essential for the body

Note: 1 cup is 125gm

  • Dark green leafy vegetables such as spinach (263 mcg per cup), turnip greens (170 mcg per cup) collard greens (177mcg per cup)
  • Citrus fruits such as oranges; each medium-sized orange holds 50 mcg of folic acid
  • Papayas – 1 medium sized papaya contains about 115 mcg of folic acid
  • Broccoli – 1 medium sized floret contains about 104 mcg of folic acid
  • Asparagus (263 mcg per cup)
  • Lentils (358 mcg per cup)
  • Black Beans (256 mcg per cup), Kidney Beans (229 mcg per cup)
  • Avocado (110 mcg per cup)
  • Brussels Sprout (100mcg per cup)
  • Peanuts (352 mcg per cup)
  • Flax Seeds (54 mcg in 2 tablespoons)
  • Cauliflower (55 mcg per cup)
  • Beets (148 mcg per cup)
  • Almonds (54 mcg per cup)
  • Corn (34 mcg per cup)

What Happens If There Is Less Folic Acid In The Body

Less folic acid in the body can lead to folate deficiency. The symptoms, though subtle, include:

  • Anaemia
  • Diarrhoea
  • Weight loss
  • Loss of appetite
  • Weakness
  • Sore tongue
  • Heart palpitations
  • Irritability
  • Headaches

In pregnant women, it can have adverse effects such low birth weight in babies, premature infants, and babies with neural tube defects (NTDs). The NTDs occurs when the neural tube fuses incorrectly during embryogenesis and causes defects. These include:

  • Spina Bifida: Incomplete development of the spinal cord which leads to babies being permanently disabled.
  • Anencephaly: Incorrect developments of the major parts of the brain which leads to disability and short lifespan of the baby.

Lesser folic acid is also related to pregnancy complications, pre-eclampsia, and miscarriage. It also increases the chances of heart disease, stroke, Alzheimer’s disease and certain types of cancers in women.

Do You Need Any Supplement?

To lower the risks of Neural tube defects (NTDs) and congenital birth defects, supplements of folic acid are a must-have. Studies indicate that they reduce the chances of those disorders by 50%. If you have previously had a baby with NDT, folic acid supplements can lower your chances of another one by 70%. There is also a reduced risk of pre-eclampsia in the second trimester with the intake of regular folic acid supplements.

Natural dietary sources of folate are incapable of delivering the full required amount a day. Since they dissolve easily in water, washing and cooking destroy some of the folates present in sources such as vegetables and meats. Steaming and microwaving can help retain some of it but large quantities of food need to be consumed to meet the required amount.

Most importantly, research shows that the body absorbs folic acid better when taken as a supplement than folate that occurs in foods. Since the neural tube of the foetus develops very early in the pregnancy, many women might not even be aware of their conception at that stage. Hence folic acid vitamins before pregnancy in the body can prevent any congenital anomalies.

Although many natural foods are good sources of folates, you might still find yourself short of it every day if you are planning to conceive or are pregnant. It is best to take folic acid supplements to be on the safer side.