Importance of the vitamin
Back in 1931, the effect of this substance on the condition of pregnant women was noticed. Doctor Lucy Wills treated a certain type of anemia in expectant mothers with yeast extracts and liver. But folic acid was directly obtained from spinach leaves only in 1941. It was later discovered in lettuce, cabbage, avocado and other plant foods. The compound is present in all tissues of animals and plants, but humans do not synthesize it on their own.
There are bacteria in the intestines that are capable of producing vitamin B9, but their contribution is insignificant. The explanation for this is simple: microorganisms live in the colon, and absorption of the vitamin occurs in the upper parts of the small intestine. Therefore, a sufficient amount of vitamin should be supplied to the body daily with food. But folacin cannot withstand heating: when cooking vegetables and meat, up to 95% of the beneficial substance is lost. Even long-term storage leads to a decrease in the proportion of folates in plants: after three days, only 30% of the original amount remains in freshly cut lettuce.
400 mcg per day is the dosage of folic acid recommended by WHO during pregnancy. The vitamin is important to the body for a number of reasons.
- Blood. Participates in the formation of young red blood cells and hemoglobin. With a deficiency, folate deficiency anemia develops.
- Squirrels. Actively participates in the synthesis of serotonin, thymine, adrenaline, and through them - in the formation of many proteins and DNA molecules.
- Nervous system. It is an integral part of the metabolic chain of neurohormones, improves the transmission of impulses, affects the cognitive sphere (thinking, memory, emotions). It is part of some components of nervous tissue.
- Immunity. Stimulates and supports the body's defenses, affects the bone marrow and takes part in the formation of leukocytes.
The influence of consumed foods and medications on the absorption of vitamin B9
In general, the human liver usually contains reserves of folic acid that last for 3-6 months. However, during pregnancy, the need for this vitamin increases sharply, and its deficiency occurs.
When a doctor prescribes a dosage of folic acid during pregnancy, the following factors that reduce the absorption of this vitamin must be taken into account:
- Drinking alcoholic beverages, strong tea;
- Taking contraceptive medications;
- Taking high doses of aspirin;
- Administration of corticosteroid hormones.
Also, the absorption of folic acid is impaired when taking nitrofurans, sulfonamides, antimetabolites, and antihyperlipidemic drugs. A deficiency of this vitamin can develop when antituberculosis and antiepileptic drugs are prescribed.
Expectant mothers who, as prescribed by a doctor, take large doses of folic acid during pregnancy for a long time should keep in mind that this can lead to a lack of vitamin B12 in the body and the occurrence of latent megaloblastic anemia. If a pregnant woman suffers from epilepsy, you need to know that taking folacin may increase the severity of seizures.
And remember, the main thing is to never engage in self-diagnosis and self-medication; it is much better to consult a competent doctor.
Role during gestation
The special effect of folates on childbearing became known more than 50 years ago. Animal experiments have shown that a lack of vitamin B9 leads to the development of severe developmental defects in offspring. Further studies in humans confirmed that adding folic acid to the diet of pregnant women significantly reduces the incidence of defects not only in the neural tube, but also in the cardiovascular and genitourinary systems, and also prevents cleft palate.
The substance was prescribed to patients who had previously given birth to children with neural tube defects. Particular attention was paid to recurrent episodes and miscarriages with similar anomalies. This allowed the women participating in the experiments to carry and give birth to healthy children.
Therefore, since 1992, in many countries around the world, patients are required to be prescribed folic acid at the stage of pregnancy planning and in the first trimester. The drug is combined with vitamin E, which protects the cells of the embryo and promotes the formation of the placenta.
About the neural tube
The neural tube is an embryonic organ, the formation of which ceases by the 28th day of the embryo’s life. Subsequently, the brain, spinal cord and nerve processes are formed from it. Organ defects occur with a frequency of 1-10 cases per 1000 births. Their occurrence is rarely associated with genetic or chromosomal abnormalities, and most often is a consequence of folate deficiency or exposure to a viral infection.
Consequences of improper development of the neural tube:
- anencephaly - complete or partial absence of the cerebral hemispheres;
- spina bifida - spina bifida.
There are also variants of neural tube failure, when a cystic spina bifida forms in the cleft or the cleft occurs in more than just one area of the spinal cord.
About homocysteine
Recent studies show that folates affect not only the formation of the fetal nervous system. Many obstetric pathologies are associated with the state of hyperhomocysteinemia. Homocysteine is an amino acid whose metabolism occurs with the participation of folic acid and its compounds. In pregnant women, its concentration is lower than in others and is 3-5 µmol/l.
An increase in homocysteine concentration leads to disruption of microcirculation and the formation of microthrombosis. In obstetric practice, the following pathological conditions are associated with hyperhomocysteinemia:
- recurrent miscarriage;
- gestosis;
- premature detachment of a normally located placenta;
- placental insufficiency;
- intrauterine growth retardation.
If a woman has a tendency to thrombosis and is diagnosed with fetoplacental insufficiency, then folic acid can be useful up to the ninth month of gestation.
About folate deficiency
Folate deficiency is observed if the expectant mother is diagnosed with:
- diseases of the cardiovascular system;
- anemia;
- cirrhosis, hepatitis;
- atrophic gastritis, enteritis;
- Crohn's disease;
- malabsorption syndrome;
- depression, increased anxiety;
- psoriasis;
- acne;
- acute infections;
- intoxication.
And also when taking antibiotics, corticosteroids and anticonvulsants.
Is it necessary to take folic acid during pregnancy?
Vitamin “B9” is found in food products - leafy garden greens, soybeans, broccoli, citrus fruits, green peas, carrots, bananas, yeast, liver, bread products, cheeses, cottage cheese, meat, eggs, etc. A significant amount of it is produced by microflora human intestines. However, even with proper nutrition and consumption of a large number of these foods, a vitamin deficiency in the body is quite possible.
This is due to its rapid destruction (from 50 to 90%) during the storage of greens and heat treatment of food, the use in agriculture of agents that accelerate the growth of animals, the cultivation of vegetables and herbs in greenhouses, and diseases of the gastrointestinal tract in humans. It should also be taken into account that the need for vitamin B9 increases significantly after conception. At the same time, it is believed that, due to various reasons, 60% of the population has a deficiency of the vitamin, and its daily requirement during pregnancy is covered by food by only a little more than 50%.
The main reasons for the development of such a deficiency of biologically active substances are as follows:
- lack of intake from food;
- chronic diseases of the stomach and/or intestines, leading to impaired absorption of the vitamin;
- genetic disorders in which the body lacks enzymes that affect the transformation and absorption of folate;
- taking certain medications, the main ones of which are certain anticonvulsants, sulfonamides, oral contraceptives, antacids, barbiturates, salicylates in high dosages, anti-tuberculosis drugs and some others;
- consumption of alcoholic beverages.
Why is folic acid prescribed during pregnancy??
Currently, vitamin B9 deficiency is the most common hypovitaminosis among pregnant women. It can manifest itself as general weakness, dizziness and headache, fatigue, weight loss, anemia, a tendency to blood clots, decreased resistance to respiratory viral infections, dysfunction of the central nervous system, irritability, depression, neuroses, memory impairment, some aggressiveness, fainting. conditions, neuritis.
Folic acid is of great importance for the synthesis of proteins and nucleic acids (DNA and RNA), which explains its exceptional role in the processes of cellular regeneration, maintaining the normal structure of all tissues and organs, and indirectly blocking transformations into malignant cells.
Folic acid in combination with other vitamins
It plays a special role in ensuring the growth and development of the fetus. Its normal content in a woman’s body is most necessary in the first trimester, when intensive cell division, tissue and organs of the unborn child are formed, and embryonic nervous tissue, as well as placental vessels, are formed especially quickly.
Vitamin deficiency is also characterized by a high risk of disruption of the formation of the fetal neural tube, the formation of which begins 2.5-4 weeks after conception, the formation of malformations of the central nervous system (hydrocephalus, anencephaly, cerebral hernias, debility, spina bifida), cleft palate. lips" and "cleft palate".
In addition, vitamin deficiency is also accompanied by:
- development of gestosis;
- premature placental abruption;
- spontaneous abortions;
- miscarriage;
- intrauterine fetal death and other complications.
How much and for how long during pregnancy you need to take folic acid to avoid its possible complications.
Dosage regimens
Folic acid is available in the form of individual tablets or can be part of combined vitamin complexes for pregnant women. But a number of researchers believe that using folates simultaneously with other vitamins is not always beneficial: some substances can inhibit absorption. Therefore, in the first trimester it is recommended to take folic acid as a separate drug, and later as part of a vitamin complex. Recommended dosages may vary.
- Healthy women. According to the manufacturers, pregnant women need to drink from 0.5 mg to 2.5 mg of the substance per day. But doctors most often prescribe 1 mg per day.
- With a complex medical history. If a woman has already given birth to children with neural tube defects, facial defects (cleft lip, cleft palate), and has also been diagnosed with recurrent pregnancy loss, then the dose is increased to 5 mg.
Combination drugs
Pharmacies sell combination drugs that contain other substances important during pregnancy, and the dosage of B9 also differs:
- "Folacin" - 5 mg;
- "Folio" - 0.4 mg;
- "Elevit" - 1 mg.
Reviews
Below are reviews from women about the use of folic acid during pregnancy.
I did not take folic acid during pregnancy. I didn’t want to stuff myself with medications; instead, I got vitamin B9 from foods. The child was born large and healthy.
Folic acid is an essential substance for human health. I took Folka at the planning stage, then throughout my pregnancy and throughout the breastfeeding period. I had no side effects from taking it.
If you want your baby to be born healthy and your pregnancy to be easy, then take folic acid. Your specialist will prescribe the required dosage and duration of use.
Overdose
An overdose when taking the substance is virtually impossible. It is non-toxic, and excess is excreted in dissolved form by the kidneys. But long-term use of very high doses leads to a decrease in the concentration of vitamin B12, which causes a completely different type of anemia. However, for such a side effect, the daily dose must be exceeded 10-15 times. And regularly, for at least three months.
There are also studies by Norwegian scientists in which a pattern was established: women with very high levels of vitamin B9 in the blood are more likely to give birth to children prone to developing asthma. But specific concentrations that increase risks have not been identified.
Therefore, the dosage of folacin recommended by the doctor is safe and necessary for the fetus and mother. Moreover, if a woman did not plan to conceive, but suddenly there was a delay and the test showed two lines, then you can start taking folate and vitamin E immediately, even before visiting the doctor.
