Folic acid during pregnancy

Folic acid is a coenzyme involved in the metabolism of one-carbon fragments the methyl, hydroxymethyl, and formyl groups. An inadequate intake of folic acid during pregnancy can result in spina bifida. 

Besides its effect on antiepileptic drugs, folic acid in animal experiments was neurotoxic and epileptogenic (27). However, when the neurotoxicity of folic acid was investigated in two groups of patients—the newborns of mothers who had taken folic acid during pregnancy and patients with parkinsonian syndromes—neurotoxicity was not found in either group (12). 

A. Role of Folic Acid Like vitamin Bp, folic acid is required for normal DNA synthesis, and its deficiency usually presents as megaloblastic anemia. In addition, deficiency of folic acid during pregnancy increases the risk of neural tube defects in the fetus. 

For certain vitamins and minerals there are indications that an intake beyond the recommended daily intake required to prevent deficiencies may be beneficial for the prevention of certain diseases. For instance, it has been established that increased intake of folic acid during pregnancy can reduce the incidence of neural tube defects in the newborn. There is also evidence to suggest that the risk of developing cardiovascular disease may be decreased by increasing vitamin E and folic acid intakes, but this remains to be firmly estabhshed. Calcium-enriched products are also believed to have a role to play in bone health. These are just a few of the growing number of links being made between vitamins and minerals and disease risk reduchon. 

Deficiency of folic acid during early pregnancy is associated with increased risk of a neural tube defect in the newborn. In the USA, cereals and grains are supplemented with folic acid in an effort to decrease the incidence of neural tube defects. The answer is (A). 

B2. Baker, H., Erdberg, R., Pasher, I., and Sobotka, H., Study of folic acid and vitamin B12 in blood and mine during normal pregnancy. Proc. Soc. Exptl. Biol. Med. 94, 513-515 (1957). 

Anti-epileptic drugs, such as phenytoin, carbamazepine and valproate, may lead to neural tube defects if administered during pregnancy. Concurrent administration of folate supplements, such as folic acid, is recommended. 

Folic acid (vitamin Bg) is a conjugate of a pteridine unit, p-aminobenzoic acid, and glutamic acid. Deficiency of folic acid leads to anaemia, and it is also standard practice to provide supplementation during pregnancy to reduce the incidence of spina bifida. 

Except during pregnancy and lactation, do not give folic acid in therapeutic doses greater than 0.4 mg/day until pernicious anemia has been ruled out. Do not include daily doses exceeding the Recommended Dietary Allowance in multivitamin preparations if therapeutic amounts are necessary, give folic acid separately. Elderly It may be prudent to consider the status of folate in people older than 65 years of age. 

Since sulfasalazine inhibits the absorption of folic acid, patients may become folate deficient during longterm therapy. Sulfasalazine decreases the bioavailabiUty of digoxin. Cholestyramine reduces the metabolism of sulfasalazine. Sulfasalazine causes a reversible decrease in sperm counts. Sulfasalazine is safe in pregnancy. 

Because both drugs may interfere with folic acid metabolism, their use during pregnancy is usually contraindicated by the potential for effects on the fetus, such as the development of neural tube defects associated with folate deficiency. The use of trimethoprim is contraindicated in patients with blood dyscrasias, hepatic damage, and renal impairment. 

Folic acid deficiency symptoms include megaloblastic anemia, glossitis, diarrhea, and weight loss. The requirement for this vitamin increases during pregnancy and lactation. 

There has been an association between folate deficiency during the first weeks of pregnancy and neural tube defects, leading to a campaign to encourage folic acid intake. In as how much UV exposure might contribute to folate deficiency is still under discussion.126-128... 

Iron is an essential nutrient that is sometimes lacking in people s diets. For that reason, physicians often recommend iron for people with certain health conditions, such as iron-deficiency anemia. Some iron products are available without a prescription, either as single-ingredient iron pills or in combination with vitamins or other minerals, including pediatric vitamins with iron. Drugs that contain iron and folic acid are available by prescription and are principally used by women during pregnancy. 

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