The evidence is strong
that folic acid supplementation at 400 mcg per day before and during
pregnancy can reduce or eliminate neural tubes deficits that occur in the
first 12 weeks of pregnancy. search optimization companies http://seotopten.com/
Neural tube deficits
include anencephaly, meningomyelocele and encephalocele, three major
abnormalities of the brain and spinal cord that are among the most common
birth defects with severe mortality and morbidity. Neural tube defects
occur with an incidence of 1-5 per 1000 births, showing marked geographic,
ethnic and temporal variations.
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Often pregnancy is
diagnosed after 12 weeks and the opportunity to avoid the problem by
supplementing mother’s diet with vitamins is too late. Folic acid is now a
nutrient officially added to cereals as a public health measure with the
hope of preventing endemic deficiency disease. In Canada, folic acid has
been added to flour and the government has initiated a major public
education campaign to recommend folic acid supplements to women who are
likely to become pregnant. In the USA folic acid was added to cereal
grains in 1998 at a dose of 140 micrograms/100 g.
Folic acid
supplementation may have additional benefits. Thereis an
increasing recognition that abnormalities in folic acid
metabolism may be a cause for miscarriage and the development
of a number of congenital abnormalities, including orofacial
cleft anomalies and urinary tract anomalies. It has also been
suggested that folic acid supplementation given before conceptionmay be associated with an increase in birth weight and a slightdecrease in the incidence of preterm labour and
small-for-gestational-agebabies.
Kadir and Economides
[i]
reported on the success of the Canadian effort to increase folic acid
intake: “2 groups report on the effect of the Canadian policy for folic
acid fortification on the incidence of NTDs.Vidia Persad and
coauthors showed a reduction of 54% in thetotal incidence
(live births, stillbirths and terminated pregnancies)of open
NTDs after 3 years of food fortification in Nova Scotia. Enza
Gucciardi and coauthors reported a reductionof 50% in the
birth incidence (live births and stillbirths)of NTDs in
Ontario from 1986 to 1999, with most of the decreaseoccurring
after 1995. They explain that the reduction after 1995in the
total incidence of NTDs is consistent with the expansionin the
late 1990s in initiatives to promote folic acid use before
conception among women of childbearing age and the 1998 policy
to fortify flour and pasta. These data are also compatible with
the success experienced in the United States with folic acid
fortification, which was associated with a reduction of 19%in
the birth incidence of NTDs.
[i]
Rezan A. Kadir and Demetrios L. Economides Neural tube defects and
periconceptional folic acid CMAJ • August 6, 2002; 167 (3)
[i]
Birnbacher R; Messerschmidt AM; Pollak AP. Diagnosis and
prevention of neural tube defects. Curr Opin Urol 2002
Nov;12(6):461-4 (ISSN: 0963-0643)
Folic acid deficiency
diseases: Anemia, Neural Tube Defects, Arterial Disease, Dementia,
Parkinson’s Disease, Colon and Breast Cancer
RDA 200 ug/day; 400 ug
during pregnancy; 280 ug during lactation
Supplement
Recommendation: 400 to 1000 ug/day
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