Folic acid, taken in supplement form starting at least one month before conception and continuing through the first trimester of pregnancy, greatly reduces the risk of spina bifida and other neural tube defects.
Get folic acid first
It's critical to have enough folic acid in your system by the early weeks of pregnancy to prevent spina bifida. Because many women don't discover that they're pregnant until this time, experts recommend that all women of childbearing age take a daily supplement of 400 micrograms (mcg) of folic acid.
Several foods, including bread, pasta, rice and breakfast cereals, are fortified with 400 mcg of folic acid per serving. Folic acid may be listed on food packages as folate, which is the natural form of folic acid found in food.
If you're actively trying to conceive, most pregnancy experts believe supplementation of at least 400 mcg of folic acid a day is the best approach for women planning pregnancy.
Your body doesn't absorb folate as easily as it absorbs synthetic folic acid, and most people don't get the recommended amount of folate through diet alone, so vitamin supplements are necessary to prevent spina bifida.
And, it's possible that folic acid will also help reduce the risk of other birth defects, including cleft lip, cleft palate and some congenital heart defects.
It's also a good idea to eat a healthy diet, including foods rich in folate or enriched with folic acid. This vitamin is present naturally in many foods, including:
- Citrus fruits and juices
- Egg yolks
- Dark green vegetables, such as broccoli and spinach
When higher doses are needed
If you have spina bifida or if you've given birth to a child with spina bifida, you'll need extra folic acid before you become pregnant.
If you're taking anti-seizure medications or you have diabetes, you may also benefit from a higher dose of this B vitamin. In these cases, the recommended dose of folic acid may be up to 4,000 mcg (4 mg) beginning one month prior to conception and during the first few months of pregnancy.
However, check with your doctor before taking additional folic acid supplements.
Aug. 27, 2014
- Spina bifida: Facts. Centers for Disease Control and Prevention. http://www.cdc.gov/NCBDDD/spinabifida/facts.html. Accessed June 13, 2014.
- Spina bifida fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/spina_bifida/detail_spina_bifida.htm. Accessed June 13, 2014.
- Fieggen G, et al. Spina bifida: A multidisciplinary perspective on a many-faceted condition. South African Medical Journal. 2014;104:213.
- Ferri FF. Ferri's Clinical Advisor 2014: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2014. https://www.clinicalkey.com. Accessed June 13, 2014.
- McLone DG, et al. Pathophysiology and clinical manifestations of myelomeningocele (spina bifida). http://www.uptodate.com/home. Accessed June 13, 2014.
- Second trimester maternal serum screening. LabTestsOnline. http://labtestsonline.org/understanding/analytes/triple-screen/tab/sample/. Accessed June 16, 2014.
- Hochberg L, et al. Prenatal screening and diagnosis for neural tube defects. http://www.uptodate.com/home. Accessed June 16, 2014.
- Grivell RM, et al. Repair procedures for spina bifida for improving infant and maternal outcomes (Protocol). Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008825/abstract. Accessed June 16, 2014.
- McLone DG, et al. Overview of the management of myelomeningocele (spina bifida). http://www.uptodate.com/home. Accessed June 13, 2014.
- Dietary supplement fact sheet: Folate. Office of Dietary Supplements. http://ods.od.nih.gov/factsheets/folate. Accessed June 13, 2014.
- Riggin EA. Decision Support System. Mayo Clinic, Rochester, Minn. June 12, 2014.
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