Folic Acid Before Pregnancy: When to Start, Benefits & more

Taking Folic Acid Before Pregnancy – Why Is It Important?

Medically Reviewed By
Archana Shah (Diabetologist/Nutritionist/Dietitian)
View more Diabetologist/Nutritionist/Dietitian Our Panel of Experts

If you wish to deliver a healthy baby, you need to eat healthy food during pregnancy and when you’re trying to conceive. One of the nutrients you would want to get enough of during and before pregnancy is folic acid. Folic acid is a superhero during pregnancy as it can prevent severe birth defects in the baby. It is crucial to have it in adequate amounts before conception and especially in the first few weeks of pregnancy for the proper development of the foetus.

What Is Folic Acid?

Folic acid, which is also known as vitamin B9, is one of the B vitamins that come under the classification of Folate. It is a synthetic form of vitamin B9 which is essential for the body’s development and to ensure good health. They are critical compounds required for the process of production and maintenance of cells along with the synthesis of DNA and RNA. They are instrumental in preventing changes to the DNA and thus, preventing cancer. Therefore, folic acid is especially important during periods of cell division and rapid growth such as pregnancy and infancy.

Folic acid is naturally found in foods such as whole grains, oranges, dark green leafy vegetables, pulses, liver, avocados, spinach, beetroot etc. The amount of folic acid from natural sources may not be enough to provide for the needs of the body. To combat this, food manufacturers often add it to some breakfast cereals and bread to meet the daily requirement. As the body cannot synthesise folic acid, its intake must be dietary. Not consuming enough of it can lead to folate deficiency which results in a type of anaemia and weakness. Long-term supplementation of folic acid has also shown benefits in reducing the risk of cardiovascular disease and stroke.

Why Do You Need Folic Acid Before Getting Pregnant?

Folic acid plays a pivotal role in cell division and the replication of DNA. Early pregnancy (first twelve weeks) is a time of rapid growth. This is the time when the baby’s brain and nervous system begin to form. Since a significant number of pregnancies are unplanned and most women have low dietary consumption, taking folic acid before pregnancy helps protect the foetus against diseases. Studies have shown that an inadequate amount of folic acid can cause neural tube defects (NTDs) such as spina bifida. This is a condition where the protective covering that develops around the foetus’ spinal cord doesn’t close properly and leaves a gap. This can lead to nerve damage and paralysis in future. The recommended intake period is three months before pregnancy and the first three months afterwards. Since folic acid helps with fertility in women, it helps to start taking it a few months before a couple tries to conceive.

How Much Folic Acid Should You Take?

The recommended amount of folic acid for women who wish to conceive is 400 micrograms (mcg) per day before the pregnancy. Folic acid supplements should be continued 12 weeks into the pregnancy to prevent a range of NTDs. For women who have health problems such as diabetes, epilepsy, and coeliac disease, the doctor might recommend a higher dose in the range of 5 milligrams (mg) a day. At the time of pregnancy, folic acid intake should be around 600mcg from four to nine months and 500mcg during breastfeeding.

Although it is very beneficial for health, sometimes folic acid supplements can result in certain side effects. The side effects of taking folic acid before pregnancy include children born with respiratory tract infections, asthma, and a higher rate of breast cancer in women.

Benefits of Consuming Folic Acid

Since the dietary intake of folic acid is low in most women, supplements are the best way to guard oneself against deficiency during pregnancy. It is best to start folic acid supplements a few months prior to conception to help protect the baby. Here’s how folic acid may benefit a woman:

  • Taking folic acid supplements can lower the chances of neural tube defects in the baby and anencephaly (incomplete development of the brain) by at least 50% along with lowering other congenital anomalies.
  • It shields the baby from risks of cleft lip palate, poor growth in the womb and low birth weight.
  • It lowers the risk of miscarriages and preterm delivery. The deficiency of folic acid increases homocysteine levels in the blood which lead to complications and unprompted abortions.
  • Folic acid is necessary for the health, growth, and development of the body’s cells.
  • It helps protect the DNA from damage which may result in cancer.
  • Folic acid helps in the production of red blood cells and prevent a certain type of anaemia.
  • It is useful in the production and functioning of the genetic map and the basic building blocks of the body’s cells.
  • Folic acid is also vital in helping the rapid cell growth in the placenta of the baby.

Foods Rich in Folic Acid

Since folic acid is a synthetically produced supplementary product, it is advisable to obtain some fraction of the total daily requirement of folates from natural dietary sources. Here are 15 folate-rich foods that you can consume. Note: 1 cup is 125gm

  • Dark green leafy vegetables such as spinach (263 mcg per cup), turnip greens (170 mcg per cup) collard greens (177mcg per cup)
  • Citrus fruits such as oranges; each medium-sized orange contains 50 mcg of folic acid
  • 1 medium-sized papaya (115 mcg)
  • 1 medium-sized broccoli (104 mcg)
  • Asparagus (263 mcg per cup)
  • Lentils (358 mcg per cup)
  • Black beans (256 mcg per cup); Kidney beans (229 mcg per cup)
  • Avocado (110 mcg per cup)
  • Brussels Sprout (100mcg per cup)
  • Peanuts (352 mcg per cup)
  • Flax Seeds (54 mcg in 2 tablespoons)
  • Cauliflower (55 mcg per cup)
  • Beets (148 mcg per cup)
  • Almonds (54 mcg per cup)
  • Corn (34 mcg per cup)

Foods Rich in Folic Acid

What Happens If There Is Less Folic Acid in the Body?

Less amount of folic acid in the body can lead to folate deficiency. The symptoms, though subtle, include:

  • Anaemia
  • Diarrhoea
  • Weight loss
  • Loss of appetite
  • Weakness
  • Sore tongue
  • Heart palpitations
  • Irritability
  • Headaches

In pregnant women, it can have adverse effects. A deficiency of folic acid can lead to low birth weight in babies, premature infants, and neural tube defects (NTDs). The NTDs occurs when the neural tube fuses incorrectly during embryogenesis and causes defects. These include:

  • Spina Bifida: Incomplete development of the spinal cord which leads to babies being permanently disabled.
  • Anencephaly: Incorrect developments of the major parts of the brain which leads to disability and short lifespan of the baby.

Lesser folic acid is also related to pregnancy complications, pre-eclampsia, and miscarriage. It also increases the chances of heart disease, stroke, Alzheimer’s disease and certain types of cancers in women.

Do You Need Any Supplements?

To lower the risk of neural tube defects (NTDs) and congenital birth defects, supplements of folic acid are a must-have. Studies indicate that they reduce the chances of those disorders by 50%. There is also a reduced risk of pre-eclampsia in the second trimester with the intake of regular folic acid supplements.

Natural dietary sources of folate are incapable of delivering the full required amount a day. Since they dissolve easily in water; washing and cooking destroy some of the folates present in sources such as vegetables and meats. Steaming and microwaving can help retain some of it but large quantities of food need to be consumed to meet the required amount.

The body absorbs folic acid better when taken as a supplement than folate that occurs in foods. Since the neural tube of the foetus develops very early in the pregnancy, many women might not even be aware of their conception at that stage. Hence folic acid vitamins before pregnancy in the body can prevent any congenital anomalies.

Although many natural foods are good sources of folates, you might still find yourself short of it every day if you are planning to conceive or are pregnant. It is best to take folic acid supplements to be on the safer side.

Also Read: Folic Acid Rich Foods during Pregnancy & Its Importance

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