From the moment that + sign appears on a pregnancy test, expectant mothers (and fathers) have plenty of planning, nesting, and stressing to do before their baby's arrival. Although tasks like picking a name can wait, making sure you get enough folic acid cannot. In fact, doctors advise women to make sure they get enough of this nutrient before they even become pregnant, as this can reduce the risk of spina bifida and related birth defects.
Now, a new study suggests another reason to be vigilant about getting enough of this vitamin: a lower risk of serious heart defects.
Folic acid (also known as folate) is a B vitamin that is important for the healthy development of the neural tubes, which eventually become a baby's brain and spinal cord. If these tubes don't develop properly in early pregnancy, a baby can be born with neural tube defects such as spina bifida, in which the bones of the spine do not come together properly. Animal studies have suggested folic acid may also play a role in preventing heart defects, although little research has been done in people.
Using government databases, researchers tracked serious heart defects among babies born in Quebec, Canada, in the 9 years before folic acid was added to grain products, and in the 7 years after. They found little variation in the annual rates of serious heart problems before folic acid was added, with around 1.64 babies in every 1,000 having these defects. In the years following, however, serious heart defects decreased, affecting around 1.47 babies in every 1,000.
This may not seem like a very big decline, but the researchers point out that treatment for serious heart defects in babies is very complex and carries a high risk of death, so even a small reduction in risk is important, as this lessens the emotional toll on families and the financial costs of care.
This is the first large study to look at folic acid and heart defects, and it was reasonably well done. But it doesn't tell us for certain that increasing women's folic acid reduces the risk of serious defects, as there could have been other factors that led to a drop in heart problems. For example, these defects are increasingly being detected in the womb, and some parents choose to end pregnancies as a result. This could mean fewer babies are born with these heart problems.
Still, the researchers argue that the connection between folic acid and serious heart defects appears to be strong, as the decline in defects directly coincided with the addition of folic acid to grain products. They also point out that the decline in heart defects occurred despite a gradual increase in factors known to raise the risk of these problems, such as women being very overweight or older when they become pregnant.
What you need to know. There's no doubt that folic acid is important to a baby's development, and this study suggests it may be even more important than previously thought. So how much should you take? Experts recommend that most women, regardless of whether they are planning a pregnancy, should get 400 micrograms daily. But your doctor may recommend a larger dose if you're trying to get pregnant and have already had a baby with a birth defect of the brain or spinal cord.
The easiest way to get enough folic acid is by taking a supplement: check the label to make sure it contains the recommended amount. Foods such as beans, lentils, fruit juices, soy milk, and green leafy vegetables are high in folic acid. Foods that have folic acid added include breakfast cereals, bread, flour, and pasta.
—Sophie Ramsey, patient editor
ConsumerReportsHealth.org has partnered with The BMJ Group to monitor the latest medical research and assess the evidence to help you decide which news you should use.
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