The professor couldn’t resist taking a survey of his class members. They were all university students pursuing graduate degrees in public health — intelligent and health-conscious, to say the least. First he queried the women: Who needs supplementation with the B vitamin folic acid?
As he recalled the results of the survey, he sounded discouraged. Only 10 percent of the female students were aware that all women of childbearing age who are capable of becoming pregnant should pay attention to their intake of folic acid. (In fact, the professor, who requested anonymity, sounded so frustrated that asking him how the men did seemed cruel.)
It has been nearly six years since the U.S. Public Health Service began recommending that all women who are capable of becoming pregnant — regardless of whether they are trying — consume 400 micrograms of folic acid every day to reduce their risk of having a baby with spina bifida or other neural-tube defects involving incomplete closure of the spinal column. They should take folic acid daily for at least one month, and preferably three months, before becoming pregnant and at least three months into their pregnancy. (Women with a history of neural-tube defects are advised by the Centers for Disease Control and Prevention in Atlanta to take 10 times the recommended dose — 4 milligrams of folic acid daily.) Because it is difficult to get 400 micrograms from diet alone, supplementation is recommended. Yet the message, as crucial as it is, is by no means common knowledge.
A survey released in 1997 by the March of Dimes found that 66 percent of the 2,001 women surveyed realized the value of folic acid in fetal development. That’s up from 52 percent in the 1995 survey. But only 23 percent of the women surveyed who were pregnant in the two years before the 1997 survey took a daily vitamin containing folic acid.
What Can You Do?
While awareness is improving, public- health experts are understandably frustrated. Because the brain and spinal cord develop very early in pregnancy, it’s optimal to begin taking folic acid long before pregnancy is even suspected so the vitamin can exert its maximum protective effect on the fetus. Doing so could cut in half the number of babies born each year in the United States with spina bifida and anencephaly (a condition in which the brain fails to form), the two major types of neural-tube defects, according to the CDC.
Taking folic acid early in pregnancy is important because the neural tube closes 24 to 28 days after conception, according to James L. Mills, M.D., chief of the pediatric epidemiology section of the National Institutes of Child Health and Human Development at the National Institutes of Health, and a renowned expert in the field. “By the time most women discover they are pregnant, the neural tube is probably closed,” he says.
So what can you do if you haven’t taken your folic acid and are well into your pregnancy? First of all, it’s never too late to start making sure to get enough of this important vitamin for you and your baby. “There may be additional benefits to taking folate through pregnancy,” says Margaret Thomson, R.N., genetic disease program specialist in the Genetic Disease Branch of the California Department of Health Services. “Pregnant women who maintain high blood levels of folate were less likely to have preterm or low birth-weight babies, according to a recent study published in the American Journal of Clinical Nutrition.”