From the Guidelines
Folic acid is a form of vitamin B9, also known as folate. It is an essential water-soluble B vitamin that plays a crucial role in many bodily functions, particularly cell growth and DNA formation 1. The recommended daily intake for most adults is 400 micrograms, though pregnant women need 600 micrograms daily to prevent neural tube defects in developing babies. Folic acid is available in supplement form and is also added to many fortified foods like cereals and bread. Natural sources of folate include leafy green vegetables, citrus fruits, beans, and liver.
Key Points
- The body needs adequate folic acid to produce healthy red blood cells and prevent anemia.
- Folic acid supports proper nervous system function and helps reduce the risk of certain birth defects.
- Folic acid works closely with vitamins B12 and C to help the body break down, use, and create new proteins.
- A systematic review by the USPSTF reaffirmed the adequacy of current folic acid supplementation guidelines with recommended daily supplementation of 400–800 μg (0.4 to 0.8 mg) in all women at average risk 1.
- The USPSTF stated that the reflected reduced magnitude of protective effect of folic acid supplementation after food fortification could be attributed to study design, and concluded with high certainty that the net benefit of folic acid supplementation is substantial with inadequate evidence for any potential harm to the mother or baby 1.
Recommendations
- All women of childbearing age should consume 0.4 mg of folic acid per day to reduce their risk of having a pregnancy affected with spina bifida or other neural tube defects 1.
- Women who have had a prior NTD-affected pregnancy are at high risk of having a subsequent affected pregnancy, and should consult their physicians for advice on folic acid supplementation 1.
- Women with a personal history of certain conditions, such as cleft lip/palate, congenital heart defects, or fetal growth restriction, may benefit from a higher dose of folic acid supplementation, such as 1 mg per day 1.
From the FDA Drug Label
Folic acid, N-[ρ-[[(2-amino-4-hydroxy-6-pteridinyl) methyl]-amino]benzoyl]-L-glutamic acid, is a B complex vitamin containing a pteridine moiety linked by a methylene bridge to para-aminobenzoic acid, which is joined by a peptide linkage to glutamic acid. Folic acid is a B complex vitamin.
- The specific vitamin is Vitamin B9. 2
From the Research
Definition of Folic Acid
- Folic acid is a form of vitamin B9, an essential nutrient required for DNA replication and various enzymatic reactions involved in amino acid synthesis and vitamin metabolism 3.
- It is crucial for growth and development, particularly during pregnancy, as folate demands increase to support fetal development 3.
Role of Folic Acid in Pregnancy
- Folic acid supplementation is recommended to prevent neural tube defects in offspring, with a daily supplement containing 0.4 to 0.8 mg (400 to 800 μg) of folic acid 4.
- The US Preventive Services Task Force concludes that folic acid supplementation has a substantial net benefit in preventing neural tube defects, with high certainty 4.
- Folic acid supplementation should be started 5-6 months before conception to reach optimal red-blood-cell folate levels 5.
Benefits and Harms of Folic Acid Supplementation
- Studies have shown that folic acid supplementation is associated with a reduced risk of neural tube defects, with no statistically significant harms reported 6.
- The benefits of folic acid supplementation include preventing neural tube defects, while potential harms such as multiple gestation, autism, and maternal cancer have not been statistically significantly associated with folic acid exposure 6.