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Everything You Need to Know About Folic Acid and Pregnancy

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Vitamin B9, or folic acid, is essential for the proper development of the baby. Supplementation is systematically given to pregnant women. How does it work?

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An editorial team specializing in nutrition. Authors of the book The Beneficial Foods (Mango Editions) and the podcast Food Revolutions.

What is folic acid?

A vitamin provided by diet

Also known as vitamin B9 or folates, folic acid is an essential vitamin for the proper functioning of our body. Its name comes from “folium,” which means leaf in Latin, as many leafy foods, like cabbage, contain folates.

Folic acid is the synthetic form added to certain foods (fortified foods and dietary supplements) while folates encompass the form naturally present in foods.

In any case, it is the same family of molecules, which is not synthesized by our body and therefore must be obtained exogenously, that is, through our diet.

Essential during pregnancy

Vitamin B9 is involved in cell growth and renewal, making it particularly important during pregnancy, when the embryo is in constant development. 

Read also | How to choose your folic acid: a pharmacist’s buying guide

In case of significant folate deficiency, malformations in the nervous system can occur. These malformations may affect the development of the embryo’s brain and spinal cord (spina bifida).

Folic acid is thus essential from the very earliest stages of pregnancy, and even beforehand. 

When and how to take folic acid?

Before pregnancy and during the first trimester

To significantly reduce the risks of growth delays or serious malformations in the unborn baby (particularly cleft lip and neural tube), folic acid is prescribed by the doctor before pregnancy or as soon as pregnancy is confirmed.

Indeed, folic acid is essential for the proper closure of the neural tube. This step occurs between the 21st and 28th day of pregnancy and is necessary for the proper functioning of the nervous system.

Studies have shown that a low level of folic acid in the body may be linked to an increased risk of depression.

Knowing that pregnant women are more prone to depression during pregnancy and after childbirth (postpartum depression), a good intake of vitamin B9 is all the more recommended.

Why take it before pregnancy?

Some studies show that taking folic acid before pregnancy promotes fertility.

Indeed, MTHFR (Methyltetrahydrofolate) is an enzyme that has a very specific function in the folate cycle (the cycle of transforming folic acid into its active form).

Its role is to transform folic acid (B9) into 5 Methyltetrahydrofolate (5MTHF), the bioactive form of vitamin B9. The role of active folic acid, 5MTHF, is crucial in the quality of oocytes, sperm, and the endometrium.

For men, the number of sperm may increase after supplementation with folic acid, combined with zinc sulfate.

Recommendations in case of pregnancy

The recommended nutritional intake for an adult woman is 400 micrograms per day of vitamin B9. This need is doubled during the first trimester of pregnancy (800 μg/day).

The HAS (High Authority of Health) therefore recommends the systematic prescription of a supplement in Vitamin B9 at a rate of 400 µg (0.4 mg) per day from the desire to conceive and at least 4 weeks before conception and until the 10th week of pregnancy (12 GW).

This supplementation is in addition to the 300 to 400 µg that should be provided by the diet daily.

Interactions and side effects

Even if they are few in number, side effects are significant if the dose ingested exceeds 1 mg per day (notably nervous system disorders). 

In case of confirmed vitamin B12 deficiency, intake of folic acid can be detrimental as it may reveal or worsen neurological disorders related to the lack of vitamin B12.

Before taking any vitamin B9, it is important to perform a blood test.

With or without a prescription?

If you become pregnant or plan to have a child in the coming months, folic acid will be prescribed by your doctor.

As it is a dietary supplement, you can also find it in pharmacies without a prescription. On your side, make sure to have a balanced diet, rich in vitamin B9, to avoid any deficiency.

Before taking any supplements, consult a doctor for advice.

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Folic acid is prescribed by the doctor before pregnancy

Where can it be found in our diet? 

Foods rich in folic acid

Outside of pregnancy and with a balanced diet, it is possible to meet our vitamin B9 needs.

But if you wish to become pregnant, make sure to include this vitamin daily in your diet. By varying your diet, vitamin B9 can be found in all your meals!

Vitamin B9 can be found in:  

  • Green vegetables: cabbage, broccoli, spinach, salads, …
  • Starches and legumes: lentils, chickpeas, red beans, potatoes, whole rice…
  • Dairy products: yogurts, cheeses (white rind and blue cheeses), fromage blanc…  
  • Meats/eggs: notably poultry liver and eggs.

Average content of Vitamin B9:

  • Poultry liver: 1440 μg/100g
  • Chickpea flour: 437 μg/100g
  • White beans, dried: 300 μg/100g
  • Raw spinach: around 200 μg/100g
  • Muesli enriched with vitamins and minerals (average food): 196 μg/100g

To vary your plates and fill up on vitamin B9, combine a legume with a green vegetable, make vegetable gratins or play with colors on the plate around a salad, for example.

How to properly preserve vitamin B9

A fragile and water-soluble vitamin, vitamin B9 deteriorates quite quickly if the foods containing it are not stored and prepared correctly. 

To ensure you consume a good amount of the vitamins present in your vegetables, limit prolonged rinsing, do not overcook them, opt for steaming and do not keep them too long in the fridge or out in the open.

Under good conditions, your salads, cabbages, and other spinach will allow you to fill up on folic acid.