Folic Acid in Pregnancy

Folic acid is a B vitamin that helps prevent neural tube defects (NTDs). The neural tube is the part of a developing baby that becomes the brain and spinal cord. When the neural tube does not close properly, a baby is born with an NTD. NTDs include spina bifida, hernia of the spinal cord, and the absence of part of, or all of the brain (anencephaly).

Take folic acid at least 4 weeks before getting pregnant and through the first 3 months of pregnancy. This is when the neural tube is developing. It is available in most multivitamins, as a folic acid-only supplement, and in some foods. Taking the right amount of folic acid before conception and during pregnancy lessens the chances of having a baby born with an NTD. Giving folic acid will not affect a neural tube defect if it is already present.

DIAGNOSIS

  • An Alpha-Fetoprotein (AFP) blood or amniotic fluid test will show high levels of the alpha-feto protein if a woman is carrying a baby with an NTD. This test is done on all pregnant women in the first trimester.

  • An ultrasound may detect an NTD.

WHAT YOU CAN DO:

  • Take a multivitamin with at least 0.4 milligrams (400 micrograms) of folic acid daily at least 4 weeks before getting pregnant and through the first 12 weeks of pregnancy.

  • If you have already had a pregnancy affected by an NTD, take 4 milligrams (4,000 micrograms) of folic acid daily. Take this amount 1 month before you start trying to get pregnant and continue through the first 3 months of pregnancy.

  • Talk to your caregiver if you are taking medicines for seizures. Your caregiver will be able to manage your seizure medicines and your pregnancy in the best way.

FOLIC ACID IN FOODS

Eat a healthy diet that has foods that contain folic acid, the natural form of the vitamin. Such foods include:

  • Fortified breakfast cereals.

  • Lentils.

  • Asparagus.

  • Spinach.

  • Organ meats (liver).

  • Black beans.

  • Peanuts (eat only if you do not have a peanut allergy).

  • Broccoli.

  • Strawberries, oranges.

  • Orange juice (from concentrate is best).

  • Enriched breads and pasta.

  • Romaine lettuce.

TALK TO YOUR CAREGIVER IF:

  • You are in your first trimester and have high blood sugar.

  • You are in your first trimester and have an oral temperature above 102° F (38.9° C).

  • You are in your first trimester and had sauna treatments.

  • You are pregnant (or want to become pregnant) and take a prescription medicine called valproic acid.

In almost all cases, a fetus found to have an NTD will need specialized care that may not be available in all hospitals. Talk to your caregiver about what is best for you and your baby.