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The importance of folate in pregnancy
Obstetrics 

Today I want to talk to you about a topic that’s really important in pregnancy and that quite frankly, I’m shocked to find that very commonly women don’t do this when they’re trying to fall pregnant, that is, take folate. Simple really.

Folate supplementation is essential. Folate is vitamin B9. It’s essential for our bodies to grow and develop. Now if you’re a rapidly growing fetus, obviously you’re going to need more folate.

So, in the baby, folate is needed for the formation of what is called the neural tube, so this is the layer of cells that go on to become the spinal cord and brain. Deficiencies of folate obviously affect that formation. They can cause, what’s called in the baby, a neural tube defect. These defects can affect the baby’s vertebrae, spinal cord, skull and again brain. A common example of a neural tube defect is spina bifida and that’s something that I’m sure a lot of you have heard about.

Where do you get folate?

Natural dietary sources of folate include leafy green vegetables, legumes, red meat, fruits and avocado. If you’re not pregnant, you should be able to get enough folate for your own needs from your diet. But pregnancy – again, rapidly developing fetus – increases your needs. They go from about 400 micrograms per day to 600 micrograms per day. So, if you want to fall pregnant, you should, without exception, take a folate supplement.

The recommendation actually is that all pregnant women should take a folate supplement containing a minimum additional 400 micrograms per day. Here’s the kicker. You should start taking this at least four weeks prior to conception and then continue taking it for the first three months of your pregnancy.

Some women are actually at increased risk of neural tube defects and need to take a much higher dose of five milligrams per day.

Ensuring an adequate folate intake reduces the risk of neural tube defects by a whopping fifty percent. So that means half of them can be prevented. Now, I would actually say that at least half the women I see for their first appointment when they’re pregnant, have not been taking folate when they conceived. Interestingly, research actually shows that while it is essential at the start and less importantly at the end, the proportion of women taking it actually increases as the pregnancy goes on. We’ve got that in reverse so this needs to change.

So, if you’re trying to fall pregnant, get on folate and be on it for four weeks prior to conceiving.

Brad Robinson
Obstetrician Gynaecologist (OBGYN)
Greenslopes Obstetrics and Gynaecology
Greenslopes Private Hospital, Brisbane

 

Folate in pregnancy blog by Dr Brad Robinson, Brisbane Obstetrician Gynaecologist

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