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Folic Acid

Folic Acid, the Pre Pregnancy Vitamin

In 1992 the United States Public Health Service recommended that women take 400 mcg daily of folic acid prior to pregnancy. The American College on Obstetrics and Gynecology agreed. This dose of folic acid has been shown to reduce the chance of neural tube defects (NTDs) by 36% in normal women. NTDs are birth defects of the brain and spine.

Four hundred micrograms of folic acid is found in the typical over-the-counter multivitamin sold in the supermarket or pharmacy. Strictly speaking, “prenatal vitamins” are not necessary, because the non prescription regular vitamin has enough folic acid in it as well.

Prenatal vitamins make some women feel bad, constipation and stomach aches are common. Alternatives to the prenatal vitamin include a regular over the counter vitamin OR a children’s chewable vitamin.

The following abstract is just one of the MANY articles explaining the importance of folic acid Before getting pregnant. It specifies the 400 mcg dose.

  • Objective: To inform the obstetrician-gynecologist of recent scientific evidence regarding the use of supplemental folic acid for prevention of neural tube defects (NTDs).
  • Data Sources: We selected English language articles via MEDLINE published from January 1990 through February 1997, using the search terms “folic acid” and “neural tube defect.” Additional sources were identified through cross-referencing and through searching selected journals published from March through October 1997.
  • Methods of Study Selection: Articles were selected on the basis of their relevance to the relationship between folate intake and NTD incidence, mechanisms of folate responsive NTD formation, and folate provision strategy. We referenced 55 papers in total.
  • Tabulation, Integration, and Results: The majority of evidence demonstrates a decreased incidence of NTDs with increased folic acid consumption. The most convincing trials were performed in Europe among women who were planning pregnancy by using multivitamin or folic acid supplements. Some studies suggest that the protective effect of folate is explained, in many cases, not through correction of dietary deficiencies, but through correction of metabolic defects. Other evidence implies that it reduces NTDs by causing abortion of affected conceptuses. Supplemental folic acid tablets are the most proven means of improving an individual’s folate status, but ensuring compliance with a strategy using vitamin tablets is problematic.
  • Conclusion: Women of reproductive age should be advised to take multivitamin supplements containing 0.4 mg folic acid daily. Women with previously affected offspring who intend to become pregnant should take daily supplementation containing 4 mg of folic acid in the periconceptional period to reduce the risk of recurrence.

Locksmith, MD, Gregory J., and Patrick Duff, MD. “Preventing neural tube defects: The importance of periconceptional folic acid supplements.” Obstetrics and Gynecology 91.6 (1998): 1027-34. Print.