Almost all women who are planning for a pregnancy are aware that if there is one prenatal vitamin they should be taking, it is folic acid. Taking the recommended dose of 400 micrograms (mcg) of folic acid before and during pregnancy has been shown to reduce the incidence of birth defects of your baby’s spinal cord and brain. In particular folic acid reduces the risk of your baby being born with spina bifida – a type of neural tube defect whereby the neural tube doesn’t close properly, resulting in an abnormal spine and vertebrae.
And now there appear to be additional benefits from taking folic acid before and during pregnancy, according to a new study published in the prestigious medical journal JAMA Psychiatry. This study used magnetic resonance imaging scans to assess the brains of 1400 children who were born just before, during, or after the rollout of government-mandated fortification of grain products for prevention of spinal cord abnormalities. This fortification doubled the levels of folic acid in women of childbearing age. The study found that children and adolescents who were exposed to folic acid fortification during their mother’s pregnancy had changes in their cerebral cortex, compared with the group that was not exposed to folic acid. These differences were characterized by delayed thinning of the cerebral cortex and significantly thicker brain tissue in areas of the brain that are associated with schizophrenia. For those who were born during the rollout period, the changes were intermediate between these two groups. Although thinning of the cerebral cortex is a normal part of brain development, early and accelerated thinning is associated with autism and symptoms of psychosis. Importantly, as well as changes in imaging, data from this study also showed that the group who were exposed to folic acid actually experienced fewer psychosis symptoms, compared with the other two groups.
Other studies have also showed a substantial reduction in the risk of autism in women who took folic acid early in pregnancy but unlike the study above, no imaging evaluations were performed.
What exactly is folic acid?
Folic acid is a man-made form of a B vitamin called folate. It plays a crucial role in the production of red blood cells and helps your baby’s neural tube develop into his or her brain and spinal cord. Folate can be found naturally in dark green vegetables and citrus fruits but the best food source is folic-acid fortified grains, such as wheat and corn.
Good food sources of folate include:
- 400 mcg: Breakfast cereals fortified with 100% of the daily value (DV), 3/4 cup
- 215 mcg: Beef liver, cooked, braised, 3 oz
- 179 mcg: Lentils, mature seeds, cooked, boiled, 1/2 cup
- 115 mcg: Spinach, frozen, cooked, boiled, 1/2 cup
- 110 mcg: Egg noodles, enriched, cooked, 1/2 cup
- 100 mcg: Breakfast cereals, fortified with 25% of the DV, 3/4 cup
- 90 mcg: Great Northern beans, boiled, 1/2 cup
When should I start taking folic acid?
Birth defects usually occur during the first 3 or 4 weeks of pregnancy and it is during this period that your baby’s spinal cord and brain are developing, so it is very important to have adequate levels of folate in your system during these early stages. Therefore, the Centers for Disease Control recommends that all women planning to get pregnant take folic acid for at least one month before conception and in fact, they recommend that all women of childbearing age take folic acid every day, so you would be fine to start taking it even earlier. One study showed that women who took folic acid for a year before conceiving cut their chances of having a preterm birth by 50 percent or more.
How much folic acid should I take?
The recommended dose for all women of childbearing age is 400 micrograms per day. If you are taking a prenatal supplement or a multivitamin, check the packaging to make sure that it contains the recommended amount.
Here are the specific amounts recommended before, during, and after pregnancy:
- 400 micrograms while trying to conceive
- 400 micrograms during the first three months of pregnancy
- 600 micrograms from month four until the end of pregnancy
- 500 micrograms while breastfeeding
In addition, if you or your family has a history of neural tube defects, you should take 4000 micrograms (4 grams) of folic acid per day.
Additional benefits of taking folic acid
Folic acid doesn’t just protect against neural tube defects and possibly psychosis and autism, but can also protect against several other adverse health outcomes for both your baby and you.
As well as reducing the risk of miscarriage and premature birth, folic acid can reduce the risk of your baby having:
- Cleft lip and palate
- Low birth weight
- Poor growth in the womb
Folic acid may have several health benefits for you, such as reducing your risk of:
- Pregnancy complications, such as preeclampsia
- Alzheimer’s disease
- Some types of cancers
- Heart disease