The Critical Role of Folic Acid in Pre-conception to Early Pregnancy
Pregnancy demands a lot from you and your body. For both your own health and the development of your child, it is important to maintain a balanced diet with adequate nutrition. If you are not mindful of your diet, you may end up deficient in some key nutrients. Deficiencies in Vitamin D, Calcium, Iron, and especially folic acid tend to be common among pregnant women1. In this article, we will look into the role folic acid plays in your pregnancy, from pre-conception to the early stages.
What is Folic Acid?
Folic acid is a synthetic form of the B vitamin folate2. While it aids in the creation of cells and DNA replication, it is also important for your baby’s growth and development as a fetus3. Both natural folates and folic acid are converted into the biologically active form, 5-MTHF (5-Methyltetrahydrofolate or methylfolate).4 This form of folate is the predominant form found in the bloodstream and umbilical cord.
Folate is a natural component of a range of food items from vegetables (asparagus, brussel sprouts, spinach, etc.), fruits (oranges), nuts and more. On the other hand, certain processed foods may incorporate folic acid during their manufacturing process. Examples of these may include enriched breads, fortified cereal, and so on. Folic acid is also manufactured as part of dietary supplements.
What can it do for your baby?
Folate is an essential nutrient for your baby and serves a range of functions. It aids in formation of their fetal cells and stimulates blood cell production (hematopoiesis). Folate also contributes to the development of the baby’s organs and tissues, as well as their nervous system. 5 6
Having an adequate amount of folate in your body also reduces the risk of several birth abnormalities, such as neural tube defects, urinary tract defects, pyloric stenosis, and congenital heart disease7. These functions mean that a folate or folic acid deficiency has the biggest impact in the early stages of pregnancy, from pre-conception up to the first trimester.8
However, not all women are capable of fully processing folic acid. Since folic acid is activated by different enzymes when digested, women with certain genetic variants (polymorphisms) may have an impaired ability to enable this activation. 9 10 Up to 50% of the population may have this polymorphism, which means that you and your baby may not be able to enjoy the full benefits of folic acid. 11 12 Another form of folate called L-methylfolate (Metafolin) is biologically active and exists independently of this activation process, so all women can access these benefits. 13 14
Ways to Prevent Folic Acid Deficiency
Folic acid plays an important role in the early stages of your baby’s development. It aids in cell production, the formation of the organs and tissues, and helps reduce the risk of different birth defects.
To avoid the potential for folic acid deficiency, organizations such as the International Federation of Gynecology and Obstetrics (FIGO) recommend supplementing your diet with fortified foods and folic acid supplements.1 Consuming about 400 µg to 1 mg folic acid is recommended as ideal in maximizing these benefits, 15 both for women who are planning to get pregnant (at least 30 days before conception) and pregnant women at least until the end of their first trimester.7
MULTIVITAMINS AND MINERALS (ELEVIT® PRE-CONCEPTION) contains a range of vitamins and minerals, including 800 μg of folate composed of 400 μg of folic acid and 451 μg of Levomefolate calcium (active form). With a balanced diet and exercise, MULTIVITAMINS AND MINERALS (ELEVIT® PRE-CONCEPTION) taken at least one month prior to and during pregnancy may reduce the risk of neural tube defects. You can go through the early stages of your pregnancy, assured that you are meeting your and your baby’s requirements for folic acid.
If symptoms persist, consult your doctor.
ASC Reference No. B0198P090524E
1Hanson, MA & Bardsley, A. FIGO recommendations on adolescent preconception and maternal nutrition. International Journal of Gynecology and Obstetrics, 2015 131(s4); S213-253.
2Center for Food Safety and Applied Nutrition. (n.d.). Folate and folic acid on the nutrition and Supplement Facts Labels. U.S. Food and Drug Administration. https://www.fda.gov/food/nutrition-facts-label/folate-and-folic-acid-nutrition-and-supplement-facts-labels.
3Greenberg JA, Bell SJ, Guan Y, Yu YH. Folic Acid supplementation and pregnancy: more than just neural tube defect prevention. Rev Obstet Gynecol. 2011 Summer;4(2):52-9. PMID: 22102928; PMCID: PMC3218540.
4Carboni L. Active Folate Versus Folic Acid: The Role of 5-MTHF (Methylfolate) in Human Health. Integr Med (Encinitas). 2022 Jul;21(3):36-41. PMID: 35999905; PMCID: PMC9380836.
5Громова О.А., Торшин И.Ю. с соавт. Систематический анализ взаимосвязи дефицита витаминов и врожденных пороков развития
6Consilium Medicum, 2012, №6:34-40, Solé-Navais P., Cavallé-Busquets P. et al. Early pregnancy B vitamin status, one carbon metabolism, pregnancy outcome and child development. Biochimie. 2016 Jul;126:91-6.
7Czeizel AE. Int J Med Sci. 2004;1(1):50-61.
8Hanson et al. 2015.
9Princz-Langenohl R et al. Brit J Pharmacol. 2009;158:2014-2021
10Kimura M et al. J Nutr. 2003;134(1):48-56.
11Pietrzik K, Bailey L, Shane B. Folic acid and L-5-methyltetrahydrofolate: comparison of clinical pharmacokinetics and pharmacodynamics. Clin Pharmacokinet. 2010 Aug;49(8):535-48.
12Kirke PN, Mills JL, Molloy AM, Brody LC, O'Leary VB, Daly L, Murray S, Conley M, Mayne PD, Smith O, Scott JM. Impact of the MTHFR C677T polymorphism on risk of neural tube defects: case-control study. BMJ. 2004 Jun 26;328(7455):1535-6.
13Princz-Langenohl R et al. Brit J Pharmacol 2009;158:2014-2021
14Czeizel A et al. Ann Nutr Metab 2011;58:263-271.
15Cordero AM, Crider KS, Rogers LM, Cannon MJ, Berry RJ. Optimal serum and red blood cell folate concentrations in women of reproductive age for prevention of neural tube defects: World Health Organization guidelines. MMWR Morb Mortal Wkly Rep. 2015;64(15):421-423.
