Folic acid cuts risk of premature babies

Folic acid supplements can significantly cut down the chances of premature babies, if taken for a year by women before getting pregnant.

A woman who takes folate long before conception is half as likely to deliver before 32 weeks of gestation and 70% less likely to deliver before 28 weeks, a study finds. Full term is about 40 weeks.

Premature babies are, normally, at the greatest risk of complications such as cerebral palsy, mental retardation, chronic lung disease, and blindness. The earlier the delivery, the higher the risk of such complications.

But folic acid supplements taken for shorter duration were not as not as effective, according to the study reported in the Public Library of Science journal PLoS Medicine.

Women who take folic acid supplements for at least one year before they become pregnant may cut their risk of having a premature baby by half, according to research published this week in the online journal, PLOS Medicine.

Previous research had shown that women who deliver prematurely have lower-than-normal levels of folate in their blood. Small trials of folic acid supplements to prevent premature birth have given mixed results.

The study is an observational analysis based on the self-reporting of folate supplementation by 38,033 participants in an earlier trial sponsored by the National Institutes of Health (NIH).

The current study only examined singleton pregnancies and excluded pregnancies with medical or obstetrical complications such as preeclampsia, chronic hypertension, or other abnormalities.

“Through the NIH trials, we received highly accurate evidence of gestational age enabling us to determine that folate supplementation for at least one year is linked to a 70 percent decrease in very early preterm deliveries (20 to 28 weeks gestation) and up to a 50 percent reduction in early preterm deliveries of 28 to 32 weeks,” said Radek Bukowski, MD, Ph D, associate professor, in the Department of Obstetrics and Gynecology, at the University of Texas Medical Branch at Galveston, the lead study author.

It is already known that folic acid helps pregnant women. Folic acid supplementation beginning before pregnancy and continuing into the first trimester helps prevent serious birth defects of the brain and spinal cord, such as spina bifida, said Alan R. Fleischman, M.D., senior vice president and medical director of  the March of Dimes.

However, “Dr. Bukowski’s research makes us optimistic that taking folic acid for at least one year before pregnancy also may greatly reduce the risk of premature birth and reinforces our message that every woman of childbearing age should consume 400 micrograms of folic acid daily,” Dr Fleischman said.

The finding reinforces the recommendation that “all women of child-bearing age should take multivitamin supplements,” experts said.

Only 35% to 40% of such women do take supplements, according to surveys conducted by the March of Dimes and other groups.

Health authorities recommend that women of childbearing age — whether or not they plan to become pregnant — consume an additional 400 micrograms per day.

However, some nutrition experts alert not to overdo with folic acid which belong to the B group (Vitamin B9) of vitamins. Some critics believe that higher amounts could mask vitamin B12 deficiency and might raise the risk of certain cancers.

The upper limit for folic acid is 1 milligram, which includes a combination of the synthetic kind as well as natural sources of folate, as per recommendation of the Institute of Medicine’s Food and Nutrition Board.

But that amount could be easy to exceed, when you consider that 3/4 cup of 100% fortified cereal contains 400 micrograms, two slices of sandwich bread contain 50 micrograms, half a cup of boiled spinach has 100 micrograms, four asparagus spears have 85 micrograms and a multivitamin supplement contains 400 micrograms.

The March of Dimes is the leading nonprofit organization for pregnancy and baby health.

Foods that are high in folates

•      Beans and lentils
•      Peas (black-eyed peas, chickpeas, green peas)
•      Juices (orange, tomato, grapefruit, pineapple)
•      Fruits (oranges, cantaloupe, honeydew melon, avocado, papaya, raspberries)
•      Soymilk
•      Vegetables (green leafy vegetables such as spinach, lettuce, turnip greens, mustard greens, collard greens, and Chinese cabbage; broccoli; Brussels sprouts; asparagus; artichokes; okra; corn; cauliflower; potato; beets; green onions; sweet red peppers)
•      Nuts
•      Sunflower seeds
•      Peanuts and peanut butter
•      Liver
•      Giblets