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Question
Folic acid tablet is given to pregnant mothers in our country. Why do pregnant mothers need to take folic acid?
Answer
Folate is a vitamin, also known as vitamin B9. The man-made form of folate is known as Folic Acid. It occurs naturally in certain foods such as leafy green vegetables, citrus fruits, beans, pulses, nuts and whole grains. Sometimes bread, margarine and breakfast cereals are fortified with folic acid.
Adequate amount of folic acid in a pregnant mother can prevent development of certain birth defects in her unborn baby. This includes brain and spinal cord defects, cleft palate and heart or limb defects. Moreover, folic acid can prevent some childhood brain tumours. [1]
It is during the first 12 weeks of pregnancy, the baby’s brain and nervous system undergo rapid development. So it is important for the mothers to take folic acid at least during this time. It should ideally be started when the woman is planning to become pregnant and continued until completion of twelve weeks. Most mothers would require 400 micrograms (0.4 mg) of folic acid daily. [2]
Higher dose of folic acid is required for mothers with higher risk of birth defects. This includes;
- previous pregnancy affected by a related birth defect or a family history of such,
- mothers on medications for epilepsy,
- obese mothers (BMI >30)
- mothers with diabetes, coeliac disease, thalassaemia or sickle cell anaemia.
Such a mother would require 5 milligrams (mg) of folic acid daily.
Apart from supplements, the expectant mothers are advised to consume foods that are rich in folate. This includes spinach (pasali), asparagus (sathawari), black-eyed beans (kaupi), Brussels sprouts, cabbage, broccoli, baked potatoes, brown rice, granary bread, hard-boiled eggs, yeast, beef extracts and orange. [3]
Folic acid is a water-soluble vitamin (dissolves easily in water), it is lost from vegetables during cooking. This can be reduced by avoiding over-cooking and steaming or microwaving vegetables instead of boiling.
Folic acid is important for the production of red blood cells as well. Deficiency of folic acid can lead to a type of anaemia (reduced oxygen-carrying capacity of the red blood cells).
In Sri Lanka, folic acid supplements are given to all the expectant mothers at government maternity care clinics free of charge.
Authors: Arshath
References
- Royal College of Obstetricians and Gynaecologists. 2014. “Healthy eating and vitamin supplements in pregnancy.” Accessed Feb. 27, 2019. https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-healthy-eating-and-vitamin-supplements-in-pregnancy.pdf.
- NHS England. 2017. B vitamins and folic acid. March 03. Accessed Feb. 27, 2019. https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-b/.
- Patient Platform Limited. 2017. Folic Acid. May 03. Accessed Feb. 27, 2019. https://patient.info/medicine/folic-acid-folate.