Folic acid is important for all women during pregnancy

Portal ABCFarma | 05/24/2021
The evidence is scientific: This nutrient protects children against neural tube diseases such as spina bifida.
During pregnancy, women need a more balanced diet that is rich in nutrients. Vitamins, minerals and proteins help maintain the mother's health and also in the development of a healthy baby. One the countless allies in this special moment of life is folic acid.

"Folic acid is extremely important for the prevention of birth defects, especially neural tube defects, and important participant in the prevention of anemia in pregnant women. Folate participates in many cellular reactions, especially in developing organs. Several studies show the prevention of possible congenital diseases, including heart diseases and also autism," explains Dr. Renato de Sá.

The indication of folic acid supplementation is a guideline of several major global health organization, including the United States Food and Drug Administration (FDA) of the Department of Health and Human Services and the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo). This indication has been supported by several studies over the years, which prove the positive effects of this nutrient for women in the gestation period.

Information from non-scientific sources, however, can confuse the population. It is not true, for instance, that women with polymorphism (MTHFR) – a condition that causes difficulty in absorbing folic acid – should use another option of the nutrient: methylfolate. With the recommended doses of folic acid supplementation (400mcg/day), they are able to achieve the same level of protection as the general population.

"No medical society in the world indicates methylfolate for pregnant women. Having the impression that a particular component works in pharmacological terms does not mean that it is actually effective in a real biological situation. In addition, there is no study proving that this component prevents neural tube defects. Therefore, the societies do not endorse it. We know that folic acid at the correct dosage works. We can safely say this, because it has already been tested and approved by studies of great scientific value. It makes no sense to use an untested and unproven medication," the doctor said.

Dr. Renato de Sá draws attention to the correct dosage of folic acid, which is 400 micrograms. "This dosage is not random. It is recommended by the World Health Organization (WHO) in relation to the ideal dose of folic acid to be consumed daily by pregnant women, which involves three components: Food intake, another that may or may not be present in the fortification of flours, and a percentage related to supplementation that women should ingest. When we carry out this analysis, 400 micrograms is the ideal dose to reach the level recommended by the WHO for daily use. Above that, it has not been properly tested; and below that, the risks of birth defects increase. The doctor will recommend further supplementation if required. For instance, women who have had bariatric surgery may need a higher dose. Also, women who have already had children with neural tube diseases would indeed require a higher dose of folic acid supplementation when they want to get pregnant again. But the recommendation for the general population is 400 micrograms," the expert concludes.
 The intake of 400 mcg of folic acid should occur at least 30 days before conception and in the first trimester of pregnancy. Therefore, all women should use it, regardless of the variations (MTHFR polymorphism) that may exist. After all, there is confidence and security that comes from years of results, as well as scientific support.

 Neural tube closure defects (NTD)

Most problems caused by NTDs result in lesions in the brain or spinal cord. They are congenital malformations, which directly influence infant mortality rate and children's health. Not closing the neural tube can result in anencephaly – when brain tissue does not develop – and spina bifida – when the spine bones do not close properly.

* Information extracted from the DTN-Fol Webinar by interview with Dr. Renato de Sá.
With the theme: THE MYTH OF MTHFR MUTATION IN THE PREVENTION OF NTCD. Main evidence and recommendations from Brazil and the world. Held on February 4, 2021.

This content is intended exclusively for the press as a source of information. It is recommended that the content is not fully reproduced. The information disclosed in this document is only informative and cannot replace, under any circumstances, the recommendations of a doctor or trained healthcare professional, nor serve as a foundation to make a medical diagnosis or encourage self-medication. The doctor is the only competent professional to prescribe the best treatment for their patient.
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