Folic acid is the synthetic version of the B-vitamin folate. Your body needs folate to produce DNA and RNA in order to make new cells. Because fetal cells divide rapidly during pregnancy, an adequate supply of the nutrient is vital. If a deficiency of folate exists during pregnancy, the risk of birth defects, including neural tube defects such as spina bifida increases.
Spina Bifida
During the first month of pregnancy, the fetus's spinal column closes to protect the spinal cord. When this doesn't happen, it can result in damage to the cord and nerves coming from it. The most severe form of spina bifida is myelomeningocele, in which a sac of fluid containing nerves and part of the spinal cord protrudes through a hole in the baby's back. The damage causes moderate to severe disability, including loss of feeling in the lower extremities, paralysis and incontinence. A less severe form causing minor disabilities is meningocele, in which the spinal cord is not in the protruding sac. Spina bifida occulta involves a small gap in the backbone and no protrusion. It generally causes no disability.
Folate and Pregnancy
Pregnancy is a time of rapid fetal cell division. Because folate is needed for the production of DNA and RNA, a deficiency can result in birth defects. In particular, folate deficiency is linked to spina bifida and anencephaly, in which most or all of the brain doesn't develop. Avoiding folate deficiency is important for any woman who could become pregnant. The spinal column normally closes within the first month of pregnancy, but a woman often does not know she's pregnant at that point. Simply using birth control, including pills, is no guarantee that you will not become pregnant, so all women of childbearing age should be sure to get enough folate.
Recommended Intake
Women who can become pregnant need between 400 to 800 mcg of folate or folic acid each day. Women with certain disorders may need more, either because of the disease itself or medications used to treat it. If you have epilepsy, diabetes, kidney disease, liver disease, sickle cell anemia, celiac disease, lupus, rheumatoid arthritis, psoriasis, asthma or inflammatory bowel disease, or if you typically drink more than one alcoholic drink per day, ask your doctor if you need additional folic acid.
Dietary Sources and Supplements
Folate is present in beef liver, fruits, dried beans, peas, asparagus and leafy green vegetables, such as spinach and turnip greens. The Food and Drug Administration requires that enriched breads, cereals, pastas, flours and other grain products contain folic acid. Since this requirement went into effect in 1998, the number of neural tube birth defects has decreased. If you could become pregnant, eat foods rich in folate and/or take a folic acid supplement. Multivitamins and B-complex vitamins usually contain folic acid. While natural folate from food has no upper limit, the safe upper limit of folic acid is 800 mcg for ages 14 to 18 and 1,000 mcg over age 19. This includes folic acid in fortified foods, as well as supplements.
