Folic acid during pregnancy, essential?

Between the third and fourth week of pregnancy, the neural tube, the future spinal cord, closes in the foetus. It is during this period that a woman's need for folic acid increases sharply.

Folic acid during pregnancy

Definition of folic acid

Indeed, folic acid, also called vitamin B9, plays an important role in the renewal of skin and intestinal cells, in the production of red and white blood cells, in the production of DNA and RNA, our genetic material, and in the proper functioning of the nervous and immune systems. It is therefore essential for the proper development of the baby.

Where is folic acid found?

This water-soluble vitamin cannot be synthesised by the human body, so it must be provided by food. The foods richest in "folates" are, for example, orange-coloured fruits (melon, clementines, oranges, etc.), legumes (lentils, split peas, dried beans, broad beans, etc.), leafy green vegetables (spinach, cabbage, broccoli, lamb's lettuce, etc.) but also fish livers (cod liver type) or egg yolk.

It is important to remember that vitamin B9 is both heat-sensitive and photosensitive. In fact, overcooking green vegetables or foods of animal origin, as well as sustained exposure to light, can destroy folates, leading to a serum reduction in folic acid.


It is therefore recommended to eat legumes 2 to 3 times a week, to favour the greenest vegetables possible, to keep food cool and to avoid overcooking. Countries such as Canada have fortified foods with folate to limit deficiencies in the population. Examples include white flour, ready-to-eat cereals, cornmeal and pasta fortified with folic acid.

Benefits of folic acid :

A recent German study has shown that an increase in the concentration of folic acid in the diet would increase the chances of getting pregnant while reducing female infertility. Folates also help the mother-to-be strengthen her immune system, better resist fatigue and preserve her memory.

Folic acid also leads to healthier hair, skin and nails. Other studies have also shown that this vitamin B9 is believed to play a key role in spermatogenesis, the ability of men to produce sperm. Of course this only applies to men and women of childbearing age. So, if the desire to have a baby is felt, consider folic acid supplementation at least 4 weeks before conception.There is no advantage in starting to take it once pregnancy is established.

Is an overdose of folic acid dangerous?

Taken in high doses, vitamin B9 can induce neurological disorders by masking vitamin B12 if the dose of 1 mg per day is exceeded. An association between overdosage and colorectal cancer is not to be neglected. However, the latest observational studies have not yet confirmed the causal link.

However, these symptoms only concern people who have a varied diet and who do not comply with the doses of folic acid supplementation. Many people around the world do not meet their daily folic acid requirement, so there are more benefits to supplementing with vitamin B9.

What is the benefit of carrying out a vitamin B9 analysis?

Some symptoms may be indicative of a folic acid deficiency. Your doctor may prescribe a prescription for a serum folic acid test if you have the following symptoms: diarrhea, depression, loss of appetite and weight, severe stress, mood changes, anemia, fever, heart palpitations, kidney function disorder, liver and bowel disease, alcoholism, shortness of breath. Your doctor may prescribe folic acid supplementation if you are pregnant or breastfeeding, but also if you have acute infections or cancer.

Vitamin B9 deficiency can cause a megaloblastic defect. Megaloblasts are precursor cells of red blood cells. Therefore, a low serum folic acid content may help in the diagnosis. Normal blood vitamin B9 values are between 5 and 15 μg/L. A lower concentration means that a deficiency is present. It may be advisable to carry out additional tests as this deficiency may be a sign of celiac disease, which has a negative effect on the absorption of vitamins in the gastrointestinal tract.

These new tests or treatments may be necessary with a specialist, for example a specialist in blood diseases (haematologist) or a specialist in diseases of the digestive system (gastroenterologist).

What are the symptoms of folic acid deficiency?

In women during the first weeks of pregnancy, an insufficient intake of folic acid can lead to abnormalities in the closure of the neural tube. This type of abnormality is the cause of pathologies such as spina bifida (congenital disease responsible for a loss of sensitivity in the limbs and paralysis), but also encephalocele (brain that develops outside the skull) and anencephaly (partial absence of the brain).

However, prenatal diagnosis by ultrasound allows such anomalies to be detected.Women who have already had a child with a neural tube defect are at high risk of having another affected child. They must therefore supplement themselves with high doses of folate during the 3 months before pregnancy and until the end of the first trimester. Folate can reduce the risk of neural tube defects by up to 75%.

How can a folic acid deficiency be remedied?

Vitamin B9 supplementation ensures optimal fetal growth during the first three months of pregnancy while reducing the risk of anomalies linked to folic acid deficiency. The Haute Autorité de Santé recommends "the systematic prescription of vitamin B9 supplementation at a rate of 400 µg (0.4 mg) per day from the desire to become pregnant, at least 4 weeks before conception and until the 10th week of pregnancy (12 weeks of amenorrhoea)".

However, Agence Santé Publique France recommends that you do not buy food supplements without first talking to your doctor. Food supplements come in the form of multivitamin pills containing 0.4 mg of folic acid. Some women may need more folic acid. The WHO recommends that "women who have been diagnosed with a neural tube defect of the fetus or who have given birth to a child with a neural tube defect should be informed of the risk of recurrence, warned of the risk of periconceptional folic acid supplementation and offered high-dose supplementation (5 mg folic acid per day)".

It should also be noted that the contraceptive pill depletes folic acid. Therefore, any woman who wants to have a child should stop contraception at least six months before conception so that the fetus can get enough folic acid during the early stages of its development.If you have any questions, talk to a health care professional.

References

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