What is folic acid and why is it so important in pregnancy?

By Cristiano Antonino On Jan 9, 2023

Folic acid and folates are two different molecular forms of vitamin B9: it is a synthetic molecule, used in food supplements, whereas folates occur naturally in food

The supply of vitamin B9 must be ensured through food or supplementation, as the body produces it in very limited quantities.

WHAT IS FOLIC ACID GOOD FOR?

Folic acid is essential for the proliferation of the body’s cells and their differentiation, because it is involved in the synthesis of DNA, RNA and many proteins.

It is therefore particularly important for the proper development of the embryo, which is why its intake is recommended in women seeking pregnancy and in the first 12 weeks of gestation.

However, contrary to what many people believe, folic acid does not help you get pregnant.

In synergy with vitamins B12 and B6, folic acid keeps homocysteine levels in the blood low, reducing the risk of cardiovascular disease.

In addition, folic acid and vitamin B12 contribute to the production of healthy red blood cells and promote proper iron metabolism.

Other beneficial effects of folic acid are still being studied: much research suggests, for example, that it may reduce the risk of developing certain types of cancer.

WHAT ARE THE SOURCES OF FOLIC ACID?

Foods that contain folic acid (or rather folates) are green leafy vegetables (spinach, lettuce, broccoli, asparagus, Brussels sprouts), pulses (peas and beans), fruit (strawberries, oranges and kiwi), and nuts (walnuts, peanuts and almonds).

Foods rich in folic acid of animal origin are offal and liver, cheese and eggs.

In addition, folic acid can be incorporated into foods during processing (we speak here of fortified foods), mostly in rusks, breakfast cereals and fruit juices.

Synthetic folic acid can be taken as a medication and as a food supplement in tablets, sachets or ampoules, alone or combined with e.g. iron and vitamin B12.

WHAT IS THE DAILY REQUIREMENT?

The recommended dose of folic acid is 0.4 mg per day.

For women of childbearing age who plan, or do not rule out, a pregnancy and for pregnant women, the recommended dose is 0.6 mg per day. In lactation, the daily requirement is 0.5 mg per day.

In Italy, folic acid in the 0.4 mg dosage is included in the list of class A drugs, with total reimbursement: a red prescription is therefore needed to pay only the cost of the ticket.

Folic acid can be taken before or after meals.

WHAT ARE THE SYMPTOMS AND CONSEQUENCES OF FOLIC ACID DEFICIENCY?

Folic acid deficiency can lead to megaloblastic anaemia, a blood disorder manifested by tiredness, concentration problems, irritability, headaches, palpitations and shortness of breath.

Folic acid deficiency can also cause sores to appear on the tongue and inside the mouth.

Studies also suggest that folic acid deficiency may be a risk factor for depression and autism spectrum disorders.

Failure to take the recommended doses of folic acid before conception and during the first three months of gestation can result in premature birth and low birth weight, and may adversely affect the development of the foetus’ nervous system.

A folate deficiency increases the risk of neural tube defects (such as spina bifida), anencephaly (incomplete or absent brain development) and encephalocele (brain malformation).

WHAT ARE THE RISK FACTORS FOR ITS DEFICIENCY?

Certain factors can reduce folic ac. absorption or cause an increase in requirements.

These include taking certain medications (barbiturates, oestrogen), high alcohol consumption and pathologies such as insulin-dependent diabetes mellitus, coeliac disease, inflammatory bowel disease, malabsorption syndromes and mutation of the MTHFR gene, which is involved in folate metabolism.