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Taking folic acid before pregnancy is associated with a reduction in premature birth
Source: ScienceDaily News Date: 05/22/09
It is well known that women of childbearing age are recommended to take a supplement that contains folic acid, this is due to the fact that folate (folate is
the
naturally occurring form of folic acid) in very early pregnancy, before
most women even know they are pregnant, can reduce the risk of birth
defects especially spina bifida. Unfortunately many women in the UK do
not achieve good levels of folate in their daily diets or through
supplements. A concern in the UK is the rising levels of teenage
pregnancy, these young women are often not taking nutrient supplements
when they get pregnant and their diets may also be lacking in the
vitamins, minerals and essential fatty acids that are vital for the
developing foetus.
There
may be additional benefits to taking folic acid supplements before
conceiving a child. A new study(1) has found that folic acid
supplements prior to conception (and in early pregnancy) may help
prevent premature births. The study links early and pre-pregnancy folic
acid intakes to a reduced risk of premature births. Prevention of
premature birth is very important, infants born early, before 37 weeks
of pregnancy rather than the normal 40 weeks, have an increased risk of
many health and developmental problems.
It
has previously been shown that women who deliver premature babies tend
to have lower levels of folate in their blood but this study(1) wanted
to look at the effect of folate supplementation on rates of premature
birth. The researchers assessed 34,480 pregnant women, about 20% of
these had been taking folate supplements for a year or more before
getting pregnant, 36% had been taking them for less than a year and 44%
were not taking any supplements at all. 160 of the women delivered
their babies before 32 weeks of pregnancy while 1,658 women delivered
their babies before 37 weeks.
The
data showed that using folate supplements for a year or more was
associated with a 70% reduced risk of delivering a baby at 20-28
weeks. Taking the supplements for less than a year was linked to 50%
reduced risk of premature births compared to women who did not take
supplements. For deliveries between 28-32 weeks the risk was 50% lower
for women on supplements for a year or longer and 30% lower for those
taking supplements for less than a year compared to those women not
taking supplements. There was no relationship between folate
supplement use and risk of delivering a baby between 32 and 37 weeks'
gestation. The preventive effects of supplementation were most
powerful for preventing the earliest, and hence riskiest, preterm
births.
In
brief: These findings show that folate supplementation for a year or
more before conception is associated with a 50%–70% decrease in early,
but not late, spontaneous preterm births and that the longer a woman
takes folate supplements before becoming pregnant, the lower her risk
of a preterm birth. The study only shows a possible association
between folate supplementation and reduction in the risk of premature
birth. Further randomised trials are necessary to provide confirmation
of the link. It could be that taking supplements is a general marker
for healthy behaviour. However, there is a body of evidence that
suggests there could be biological reasons why folate may protect
against premature birth. Low folate levels are associated with
increased intrauterine infection which is linked to early premature
births. Folate also seems to reduce inflammation within the body
during pregnancy. Since folate is necessary preconceptionally and in
the early weeks of pregnancy in order to prevent birth defects it is
definitely worth considering long term supplementation prior to
conception.
It
is important for any woman who is planning a pregnancy to aim to eat a
consistently healthy diet rich in vegetables, fruits, healthy fats and
unprocessed meats, fish and wholegrain unrefined carbohydrates. It may
also be worth considering a broad-spectrum food-state supplement
specifically designed for pre-pregnancy in order to main good levels of
all nutrients. An omega 3 fatty acid supplement could also be
considered, especially if oily fish and nuts/seeds are not regularly
eaten. Before deciding to take any supplement during pregnancy please
discuss your thoughts with a GP, nurse or midwife.
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