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Folic Acid’s Role in Preventing Neural Tube Defects

Thursday, February 27th, 2014

Neural tube defects (NTDs) are common birth defects that present an elevated risk of serious disability and infant mortality. NTDs include spina bifida, anencephaly, and encephalocele, and occur in about 1 out of every 1000 US births. Many of these pregnancies are either terminated or spontaneously lost, resulting in about 2,500 babies born with NTDs each year.

Spina bifida occurs when the vertebra do not form properly around part of the spinal cord. The disease can be mild, with no symptoms, or it can be debilitating, affecting every aspect of a child’s life. People with a very mild form may never even know they have it until some other problem prompts a back x-ray. In more serious cases, fluid can leak out of the spine and push against the skin, forming a bulge, or spinal nerves can push out of the spinal canal and sustain damage. This can cause problems with walking, coordination, and bladder and bowel control.

Anencephaly is a birth defect in which an infant is born without parts of the brain and skull. Most babies with anencephaly die shortly after birth. Encephalocele is a rare NTD that also affects the brain. In encephalocele, the brain and the membranes that surround it protrude through an opening in the skull. This defect is often linked to nervous system problems, such as uncoordinated movement, vision problems, seizures, and developmental delays.

Folic Acid Key to Prevention

Studies such as this one show that folic acid is instrumental in preventing neural tube defects. Folic acid is a synthetic compound used to fortify foods and supplements. The term “folate” means any compound containing the same vitamin properties of folic acid, and includes both folic acid and the natural compounds found in many foods.

Folic acid is water-soluble and has no known toxicity. (However, certain vitamins found in many multivitamin supplements are toxic at high doses, so do not continue a vitamin regimen that your doctor has not approved when you are considering becoming or are pregnant.) Women of childbearing age should be getting 0.4 mg of folic acid each day. Folic acid is highly bioavailable and one of the important ingredients in prenatal vitamins, a key reason why you should be taking them if you are pregnant or thinking of becoming pregnant.

You can also up your intake by eating plenty of leafy green vegetables, citrus fruits, and whole grain breads, pastas, and other foods enriched with folic acid. And plant foods, in particular, contains many compounds that are essential for your health and which you can’t get from a pill, so don’t let your vitamin supplement be a substitute for a healthy diet. The bottom line is that when it comes to optimal prenatal nutrition, both prenatal vitamins and a healthy, balanced diet are essential.

– Yvonne S. Thornton, M. D., M. P. H.