Tuesday, 23 March 2021

Folate and pregnancy outcome



Folate is one of the vitamins famous for its roles in cell reproduction. It is needed in large amounts during pregnancy because new cells are laid down at a tremendous pace as the fetus grows and develops. At the same time, because the mother’s blood volume increases, the number of her red blood cells must rise, requiring more cell division and therefore more vitamins. Folate requirement increases during pregnancy in response to the fetal and placental growth and, maternal needs to produce Red Blood Cells (RBC), most importantly, for the prevention of Neural Tube Defects (NTDs).

Folic Acid Daily Allowance

The RDA for folic acid in pregnancy is 600 mcg, a 200 mcg increase over that for nonpregnant females.  The Institution of Medicine recommends that 400 mcg of the 600 mcg/day be provided by folate-fortified foods or supplements because it is better absorbed, with 200 mcg from food and beverages. To reduce the risk of neural tube defects for women capable of becoming pregnant, the recommendation is to take 400 µg of folic acid daily from fortified foods, supplements, or both in addition to consuming food folate from a varied diet because about 50% of pregnancies are unplanned and the neural tube closes by 28 days of gestation (before most women realize they are pregnant). Therefore supplementation with folic acid should begin before conception.

Folate Deficiency

A diet low in fresh fruits, vegetables, and fortified cereals is the main cause of folate deficiency. In addition, overcooking your food can sometimes destroy the vitamins.

Maternal folate deficiency is associated with an increased incidence of congenital malformations. Its deficiency can cause megaloblastic anemia - a condition in which you have too few RBCs. Megaloblastic anemia is the latest stage of folate deficienc and it may not present until the third trimester. Folate deficiency can also be caused by chronic alcohol abuse.

Symptoms of Folate Deficiency

Symptoms can vary from person to person. Common symptoms include:

  • Shortness of breath

  • Fast heartbeat

  • Abnormal paleness of the skin

  • Smooth or tender tongue (swollen tongue)

  • Loss of appetite/weight loss
  • Muscle weakness

  • Nausea

  • Diarrhea

  • Tingling in hands and feet


Dietary sources of folate

Sources include; spinach, fortified bread cereals, broccoli, cabbage, cauliflower, green beans,

lettuce, kidneys beans, peas, potatoes, most fruits, most nuts, brown rice, oats bran, some yoghurt, milk, eggs, salmon, beef, game(bush animals) etc.

 

Millicent Onyinyechi (RDN)

 

 

 

 

 

 

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