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Folate is one of the B Vitamins found in foods. Folic acid is the form of folate in vitamin supplements.
Folate and folic acid are important for your health and for healthy growth of an unborn baby. They are important for the normal development of a baby’s spine and brain.
Neural tube defects or NTDs are a group of serious birth defects, and spina bifida is the most common defect.
Neural tube defects occur when tissues and bone around the brain and spine of the embryo do not develop properly. These occur in the third and fourth week after conception (the first or second week after the first missed period). This could be before you know that you are pregnant.
People with spina bifida have varying degrees of paralysis, which can affect the legs, the bladder, and/or bowel function. They need lifelong medical care. The most seriously affected babies are stillborn or do not survive long after birth.
Women who take folic acid supplements and eat a diet rich in folate have a smaller chance of having a baby born with a neural tube defect.
For folic acid to be useful in preventing NTDs, it is best to take folic acid supplements at least three months before becoming pregnant and during the first three months of pregnancy. You should continue to take folic acid supplements and to eat foods high in folate throughout your pregnancy.
If you are a woman of childbearing age who plans to become pregnant, you should take 0.4 milligrams (400 micrograms) of folic acid in a vitamin supplement every day to help prevent neural tube defects.
The amount of folic acid in supplements may range from 0.4 to 1.0 milligram, but you should not take more than 1.0 milligram without consulting with your health care provider.
If you take folic acid in a multivitamin supplement, be sure it does not contain more than 10,000 IU of preformed vitamin A. Too much preformed vitamin A could increase the risk of birth defects. Preformed vitamin A is often listed as vitamin A acetate or succinate or palmitate. Beta-carotene is not preformed vitamin A.
Although folic acid helps to prevent NTDs when taken before and during for the first three months of a pregnancy, you should continue to take folic acid supplements and to eat foods high in folate throughout your pregnancy.
All women who could become pregnant should follow Eating Well with Canada’s Food Guide for a healthy, well-balanced diet.
Good dietary sources of folate include:
Note: Although liver is high in folate, pregnant women should limit the consumption of liver due to its high vitamin A content.
It is believed that about 95 per cent of all NTD pregnancies happen to women with no previous affected pregnancy or family history of NTD.
Women at highest risk of having a baby with a neural tube defect are those who have a family member who has had a baby with a neural tube defect. Women who have had a previous baby with an NTD are 15 times more likely to have another baby with this defect than the general population. If you or your partner has a neural tube defect, this also increases your risk of having a baby with a neural tube defect.
Other people at higher risk include people of certain ethnic origins, women with diabetes, and women taking certain seizure medications. If any of these apply to you, you should see your family doctor when you are planning a pregnancy. You may be advised to take a higher amount of folic acid.
The Public Health Agency of Canada estimates that there are about 260 NTD pregnancies per year. About 400 NTD births happen in Canada every year – an average of one NTD birth per 1,000 newborn babies.
Some of these could be prevented probably by supporting women to take folic acid supplements and to eat foods rich in folate before and during pregnancy.
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