What is the essence of the folic acid pills they give women during pregnancy? And what are the consequences of not taking them? Can what they provide be found elsewhere, like in food, for example?

Rita

Dear Rita,

Folic acid is an important component of nutrition. It is a component of vitamin B. complex and its importance is increased more during pregnancy as it helps in the development of brain and spinal cord. Deficiency of folic acid during pregnancy can lead to poor development of the brain and spinal cord of the baby. Folic acid deficiency is also a risk factor for congenital birth defects of brain and spinal cord in the new-born, including neural tube defect.

Folic acid also helps in the formation of red blood cells in the body and deficiency can result in anaemia. This is manifested as early fatigue, body aches, and breathlessness on exertion, palpitations, and other symptoms. As such, the requirement of all nutrients is increased during pregnancy, including that of folic acid, hence, if dietary intake is not sufficient, it can result in deficiency.

Since external and internal body parts, including brain and spinal cord, are developed during first 12 weeks of conceiving, it is recommended to start folic acid early during pregnancy. A person planning to get pregnant can also start taking it regularly. After 12 weeks, it may be stopped or can be continued, depending on haemoglobin levels. As such, there is no harm in continuous intake of folic acid during pregnancy. A study suggested that excess of vitamin B12 and folic acid during pregnancy can cause problems for the baby. But this study had many caveats and was never substantiated.

The dose recommended is 200 microgram to 5 mg. daily. It should be taken preferably at the same time every day. If one has missed a dose, another one can be taken on the scheduled time.

In nature, folic acid is present in adequate quantity in green leafy vegetables like spinach, cabbage, and broccoli. Citrus fruits like oranges, lemons, are also good sources of folic acid. Apart from folic acid, these vegetables also supply fibre in the diet. This aids in digestion and prevents constipation during pregnancy. Milk also contains folic acid, along with calcium and protein. Regular intake of these folic acid rich foods is beneficial when pregnant. In addition, folic acid supplements can also be taken.

This will help in preventing brain and spinal cord defects, as well as anaemia.

 Dr. Rachna   Pande is a  specialist in internal medicine.