Folic Acid Use By Pregnant Women On The Rise

Forty percent of American women of childbearing age now get enough folic acid to help prevent birth defects, according to a new March of Dimes Gallup survey published in the Morbidity and Mortality Weekly Report (MMWR).

The MMWR is a publication of the Centers for Disease Control and Prevention (CDC).

That is a record proportion of women, up from 32 percent in last year's survey. While it is still far from the majority of women, it is heartening progress, March of Dimes officials say.

"We're still only at 40 percent, but that's a lot better [than in past years]," says Dr. Siobhan Dolan, associate medical director for the organization. "That's a big jump. Eight percent is a big and very exciting jump."

Folic Acid Prevents Some Birth Defects

For years, the March of Dimes, as well as the CDC and other national organizations, have urged women who could become pregnant to be sure they get at least 400 micrograms of folic acid every day to prevent birth defects. This is the amount found in most multivitamins.

Folic acid is a nutrient found in some green, leafy vegetables, most berries, nuts, beans, citrus fruits, fortified breakfast cereals, and some vitamin supplements. Folic acid, a B vitamin, is sometimes called folate.

If women get adequate amounts of folic acid before pregnancy, it can reduce the risk of giving birth to children with neural tube defects, such as spina bifida, a defect in the spine, or anencephaly, a brain defect, according to the CDC.

Every year in the US, about 3,000 babies are born with neural tube defects, according to the March of Dimes.

Pollsters asked a national sample of 2,012 women ages 18 to 45 about their vitamin use, why they did or did not take folic acid, and about their awareness of the importance of folic acid to prevent birth defects, among other questions.

Seventy-seven percent of the women said they were aware of folic acid, compared to just 52 percent when the same survey was done in 1995.

While 40 percent of women now take folic acid daily in the form of multivitamins, just 28 percent did in 1995 and 32 percent did in 2003.

"In 1995, 4 percent of women knew folic acid helps prevent birth defects," Dr. Dolan comments. "But in 2004, 24 percent know that."

Women Notice Nutrients in Their Diets

The low-carb diet craze may have actually helped, Dr. Dolan notes.

"We had concerns that low-carb diets might put women in a position where they didn't benefit from fortification in the food supply," she says, referring to low-carb dieters' habit of cutting down on or eliminating breads and other carbohydrate-rich foods.

But it appears that women on low-carb diets may have paid more attention to their folic acid needs. In the new survey, 49 percent of women who said they had been on a low-carb diet in the past six months said they took a multivitamin every day with folic acid.

Always consult your physician for more information.

Online Resources

American College of Obstetricians and Gynecologists

Center for the Evaluation of Risks to Human Reproduction

Centers for Disease Control and Prevention (CDC)

November 2004

Folic Acid Use By Pregnant Women On The Rise

Folic Acid Prevents Some Birth Defects

Women Notice Nutrients in Their Diets

Nutrition During Pregnancy

Online Resources

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Find a St. John's Mercy Physician

Women's Services at St. John's Mercy

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Nutrition During Pregnancy

According to the US Food and Drug Administration (FDA), about 300 extra calories are needed daily to maintain a healthy pregnancy.

These calories should come from a balanced diet of protein, fruits, vegetables, and whole grains with sweets and fats kept to a minimum.

A healthy, well-balanced diet during pregnancy can also help to minimize some pregnancy symptoms such as nausea and constipation.

Nutrition is a primary factor in the health of the mother and the baby.

The following daily food servings for pregnant women are recommended by the American College of Obstetricians and Gynecologists (ACOG):

• 9 servings of bread and whole grains
  
  
• 4 servings of vegetables
  
  
• 3 servings of fruit
  
  
• 3 servings of milk and milk products
  
  
• 3 servings of meat and protein foods
  

These serving recommendations are for women who are of normal weight before becoming pregnant.

Underweight or overweight women should discuss their nutrition needs with their physician.

Fluid intake also is an important part of healthy pregnancy nutrition.

Women can take in enough fluids by drinking six to eight glasses of water each day, in addition to the fluids in juices and soups. An expectant mother should talk with her physician about restricting her intake of caffeine and artificial sweeteners. All alcohol should be avoided in pregnancy.

The US Public Health Service recommends that all women of childbearing age consume 400 micrograms (0.4 mg) of folic acid each day.

The most common neural tube defect is spina bifida (in which the vertebrae do not fuse together properly, causing the spinal cord to be exposed) which can lead to varying degrees of paralysis, incontinence, and sometimes mental retardation.

Folic acid is most beneficial during the first 28 days after conception, when most neural tube defects occur. Unfortunately, many women do not realize they are pregnant before 28 days. Therefore, folic acid intake should begin prior to conception.

Most physicians will prescribe a prenatal supplement before conception, or shortly afterward, to ensure all of the woman's nutritional needs are met. However, a prenatal supplement does not replace a healthy diet.

Always consult your physician for more information.