folate vs folic acid vs folinic acid and role of each
Penny cited the following
5 peer-reviewed research articles
5 professionally-backed sources
3 articles from healthcare institutions
Overview
Folate, folic acid, and folinic acid are all forms of vitamin B9, which is essential for healthy pregnancy, especially for the development of the baby’s brain and spine. Each form has unique properties, sources, and roles in the body.
Key Points
Folate
What it is:
- The natural form of vitamin B9 found in foods like leafy greens, legumes, and some fruits.
- Required for DNA synthesis, cell division, and normal growth and development, especially during pregnancy.
Role in Pregnancy:
- Supports the rapid cell growth needed for fetal development.
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Deficiency is linked to neural tube defects (NTDs), anemia, and other complications for both mother and baby.
1ArticleThe Critical Role of Folate in Prenatal Health and a Proposed Shift from Folic Acid to 5-Methyltetrahydrofolate Supplementation | Published in Georgetown Medical ReviewMenezo Y, Elder K, Clement A, Clement P. FolicAcid, FolinicAcid, 5 Methyl TetraHydroFolate Supplementation for Mutations That Affect Epigenesis through the Folate and One-Carbon Cycles. Biomolecules. 2022;12(2):197.→
Global Medical Research (GMR) - Scholastica
2ArticleFolic Acid Supplementation and Pregnancy: More Than Just Neural Tube Defect Prevention - PMCFolate (vitamin B9) is an essential ... and vitamin metabolism. Demands for folate increase during pregnancy because it is also required for growth and development of the fetus....→PubMed Central
3ArticleFolic Acid for a Healthy Baby | Johns Hopkins MedicineThe developing baby needs folate to make healthy new cells, and to make DNA and RNA (genetic material). These are cell-building blocks. Folate also is essential to form normal red blood cells and certain amino acids. These are important functions during pregnancy and infancy.→Johns Hopkins Medicine
4ArticleFolate vs. Folic Acid: What's the Difference?For people of all ages, it can be hard to maintain adequate B9 levels and meet the recommended daily amount without taking supplements. People who are pregnant or those planning to conceive need folic acid to reduce the risk of birth defects of the brain and spine (neural tube defects). The terms ...→Cleveland Clinic
Absorption:
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Folate from food is less stable and less efficiently absorbed than synthetic forms.
3ArticleFolic Acid for a Healthy Baby | Johns Hopkins MedicineThe developing baby needs folate to make healthy new cells, and to make DNA and RNA (genetic material). These are cell-building blocks. Folate also is essential to form normal red blood cells and certain amino acids. These are important functions during pregnancy and infancy.→4ArticleFolate vs. Folic Acid: What's the Difference?For people of all ages, it can be hard to maintain adequate B9 levels and meet the recommended daily amount without taking supplements. People who are pregnant or those planning to conceive need folic acid to reduce the risk of birth defects of the brain and spine (neural tube defects). The terms ...→5ArticleFolic Acid: Facts for Clinicians | Folic Acid | CDCFolic acid is more stable than folates found naturally in food. It is used in supplements and fortified foods, such as bread, pasta, some breakfast cereals, and some corn masa flour. A woman needs adequate folate in early pregnancy to properly form the neural tube, which becomes a baby's brain ...→
Centers for Disease Control and Prevention
Folic Acid
What it is:
- The synthetic form of vitamin B9 used in supplements and fortified foods (like cereals and bread).
- More stable and better absorbed than natural folate.
Role in Pregnancy:
- Proven to reduce the risk of neural tube defects (NTDs) when taken before conception and during early pregnancy.
-
Recommended daily intake for people who could become pregnant is 400 micrograms (mcg), starting at least one month before conception and continuing through the first trimester.
5ArticleFolic Acid: Facts for Clinicians | Folic Acid | CDCFolic acid is more stable than folates found naturally in food. It is used in supplements and fortified foods, such as bread, pasta, some breakfast cereals, and some corn masa flour. A woman needs adequate folate in early pregnancy to properly form the neural tube, which becomes a baby's brain ...→6ArticleAbout Folic Acid | Folic Acid | CDCIt is the only form of folate that's been shown to help prevent serious birth defects called neural tube defects (NTDs). NTDs are major birth defects of the baby's brain (such as anencephaly) and spine (such as spina bifida). NTDs happen in the first few weeks of pregnancy, often before you ...→7ArticleNutrition During Pregnancy | ACOGDuring pregnancy you need folic acid, iron, calcium, vitamin D, choline, omega-3 fatty acids, B vitamins, and vitamin C. See the below table for recommended amounts. ... Folic acid, also known as folate, is a B vitamin that is important during pregnancy.→
American College of Obstetricians and Gynecologists
8ArticleFolic acid | Office on Women's HealthEveryone needs folicacid to be healthy. But it is especially important for women: Before and during pregnancy. Folicacid protects unborn children against serious birth defects called neural tube defects. These birth defects happen in the first few weeks of pregnancy, often before a woman ...→Office on Women's Health
9ArticleHow and when to take folic acid - NHSNHS medicines information on dosage for folic acid, how to take it and what to do if you miss a dose or take too much.→nhs.uk
10ArticlePrenatal Vitamins: Folate vs. Folic Acid and the MTHFR MutationWomen in intermediate- to high-risk ... risk and the appropriate level of folic acid supplementation. ... While often used interchangeably, folate and folic acid differ slightly....→markhamfertility.com
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Higher doses (up to 4,000 mcg) may be recommended for those with higher risk factors (e.g., previous NTD-affected pregnancy, certain medical conditions).
6ArticleAbout Folic Acid | Folic Acid | CDCIt is the only form of folate that's been shown to help prevent serious birth defects called neural tube defects (NTDs). NTDs are major birth defects of the baby's brain (such as anencephaly) and spine (such as spina bifida). NTDs happen in the first few weeks of pregnancy, often before you ...→10ArticlePrenatal Vitamins: Folate vs. Folic Acid and the MTHFR MutationWomen in intermediate- to high-risk ... risk and the appropriate level of folic acid supplementation. ... While often used interchangeably, folate and folic acid differ slightly....→
Folinic Acid (and L-methylfolate)
What it is:
- Folinic acid (also called 5-formyltetrahydrofolate) and L-methylfolate (5-methyltetrahydrofolate) are active forms of folate used in the body.
- Folinic acid is available as a supplement and is sometimes used in medical settings, especially for people with specific metabolic or absorption issues.
Role in Pregnancy:
-
Folinic acid and L-methylfolate can be used by the body without needing conversion by the MTHFR enzyme, which is important for people with certain genetic variations (MTHFR mutations) that reduce their ability to process folic acid efficiently.
2ArticleFolic Acid Supplementation and Pregnancy: More Than Just Neural Tube Defect Prevention - PMCFolate (vitamin B9) is an essential ... and vitamin metabolism. Demands for folate increase during pregnancy because it is also required for growth and development of the fetus....→11ArticleFolic acid in pregnancy - ScienceDirectFolate (vitamin B9) is one of thirteen vital vitamins and is found in dietary products, while folic acid is the synthetic supplement used to fortify f…→
sciencedirect.com
12ArticleMultivitamin Supplementation During Pregnancy: Emphasis on Folic Acid and l-Methylfolate - PMCIncreased plasma homocysteine is ... adverse pregnancy outcomes. In a study by Lamers and colleagues,1 healthy women were randomly assigned to consume 400 µg of folicacid, 416 µg of Lmethylfolate (the bioequivalent dose of folicacid), and 208 µg of l-methylfolate (half dose). Each group experienced increases in plasma folate and decreases ...→13ArticleActive Folate Versus Folic Acid: The Role of 5-MTHF (Methylfolate) in Human Health - PMCWhile implementing specific ... the absorption of folate is much more effective with fortified foods and supplements, such as 5-MTHF/folate and folic acid. In fact, in the last decades, the main form of folate supplementation has been FA. Prescription of FA to women in the preconception period ...→ -
However, only folic acid supplementation has been proven in large studies to prevent neural tube defects. There is not enough evidence to recommend folinic acid or L-methylfolate as a replacement for folic acid for the general population.
10ArticlePrenatal Vitamins: Folate vs. Folic Acid and the MTHFR MutationWomen in intermediate- to high-risk ... risk and the appropriate level of folic acid supplementation. ... While often used interchangeably, folate and folic acid differ slightly....→
How They Work in the Body
Conversion and Activation
- Folic acid must be converted in the body to its active form (L-methylfolate) through several steps, including one that uses the MTHFR enzyme.
- Folate from food is also converted to active forms, but less efficiently.
-
Folinic acid and L-methylfolate are already in active forms and can be used directly by the body, which is why they may be considered for people with MTHFR mutations.
11ArticleFolic acid in pregnancy - ScienceDirectFolate (vitamin B9) is one of thirteen vital vitamins and is found in dietary products, while folic acid is the synthetic supplement used to fortify f…→12ArticleMultivitamin Supplementation During Pregnancy: Emphasis on Folic Acid and l-Methylfolate - PMCIncreased plasma homocysteine is ... adverse pregnancy outcomes. In a study by Lamers and colleagues,1 healthy women were randomly assigned to consume 400 µg of folicacid, 416 µg of Lmethylfolate (the bioequivalent dose of folicacid), and 208 µg of l-methylfolate (half dose). Each group experienced increases in plasma folate and decreases ...→13ArticleActive Folate Versus Folic Acid: The Role of 5-MTHF (Methylfolate) in Human Health - PMCWhile implementing specific ... the absorption of folate is much more effective with fortified foods and supplements, such as 5-MTHF/folate and folic acid. In fact, in the last decades, the main form of folate supplementation has been FA. Prescription of FA to women in the preconception period ...→
Summary
- Folate is the natural form in foods; folic acid is the synthetic, stable, and well-absorbed form in supplements and fortified foods; folinic acid and L-methylfolate are active forms sometimes used for people with absorption or genetic issues.
- Folic acid supplementation before and during early pregnancy is the only intervention proven to reduce the risk of neural tube defects.
- Most guidelines recommend 400 mcg of folic acid daily for anyone who could become pregnant, as it is difficult to get enough from food alone.
- Folinic acid or L-methylfolate may be considered in special cases, but are not standard for NTD prevention in the general population.
If you have questions about which form is best for your individual needs—especially if you have a known MTHFR mutation or other health concerns—it might be beneficial to discuss this with your OB/GYN, who can work with you on your personal course of care.
References:
1
Article
The Critical Role of Folate in Prenatal Health and a Proposed Shift from Folic Acid to 5-Methyltetrahydrofolate Supplementation | Published in Georgetown Medical Review
Menezo Y, Elder K, Clement A, Clement P. FolicAcid, FolinicAcid, 5 Methyl TetraHydroFolate Supplementation for Mutations That Affect Epigenesis through the Folate and One-Carbon Cycles. Biomolecules. 2022;12(2):197.
2
Article
Folic Acid Supplementation and Pregnancy: More Than Just Neural Tube Defect Prevention - PMC
Folate (vitamin B9) is an essential ... and vitamin metabolism. Demands for folate increase during pregnancy because it is also required for growth and development of the fetus....
3
Article
Folic Acid for a Healthy Baby | Johns Hopkins Medicine
The developing baby needs folate to make healthy new cells, and to make DNA and RNA (genetic material). These are cell-building blocks. Folate also is essential to form normal red blood cells and certain amino acids. These are important functions during pregnancy and infancy.
4
Article
Folate vs. Folic Acid: What's the Difference?
For people of all ages, it can be hard to maintain adequate B9 levels and meet the recommended daily amount without taking supplements. People who are pregnant or those planning to conceive need folic acid to reduce the risk of birth defects of the brain and spine (neural tube defects). The terms ...
5
Article
Folic Acid: Facts for Clinicians | Folic Acid | CDC
Folic acid is more stable than folates found naturally in food. It is used in supplements and fortified foods, such as bread, pasta, some breakfast cereals, and some corn masa flour. A woman needs adequate folate in early pregnancy to properly form the neural tube, which becomes a baby's brain ...
6
Article
About Folic Acid | Folic Acid | CDC
It is the only form of folate that's been shown to help prevent serious birth defects called neural tube defects (NTDs). NTDs are major birth defects of the baby's brain (such as anencephaly) and spine (such as spina bifida). NTDs happen in the first few weeks of pregnancy, often before you ...
7
Article
Nutrition During Pregnancy | ACOG
During pregnancy you need folic acid, iron, calcium, vitamin D, choline, omega-3 fatty acids, B vitamins, and vitamin C. See the below table for recommended amounts. ... Folic acid, also known as folate, is a B vitamin that is important during pregnancy.
8
Article
Folic acid | Office on Women's Health
Everyone needs folicacid to be healthy. But it is especially important for women: Before and during pregnancy. Folicacid protects unborn children against serious birth defects called neural tube defects. These birth defects happen in the first few weeks of pregnancy, often before a woman ...
9
Article
How and when to take folic acid - NHS
NHS medicines information on dosage for folic acid, how to take it and what to do if you miss a dose or take too much.
10
Article
Prenatal Vitamins: Folate vs. Folic Acid and the MTHFR Mutation
Women in intermediate- to high-risk ... risk and the appropriate level of folic acid supplementation. ... While often used interchangeably, folate and folic acid differ slightly....
11
Article
Folic acid in pregnancy - ScienceDirect
Folate (vitamin B9) is one of thirteen vital vitamins and is found in dietary products, while folic acid is the synthetic supplement used to fortify f…
12
Article
Multivitamin Supplementation During Pregnancy: Emphasis on Folic Acid and l-Methylfolate - PMC
Increased plasma homocysteine is ... adverse pregnancy outcomes. In a study by Lamers and colleagues,1 healthy women were randomly assigned to consume 400 µg of folicacid, 416 µg of Lmethylfolate (the bioequivalent dose of folicacid), and 208 µg of l-methylfolate (half dose). Each group experienced increases in plasma folate and decreases ...
13
Article
Active Folate Versus Folic Acid: The Role of 5-MTHF (Methylfolate) in Human Health - PMC
While implementing specific ... the absorption of folate is much more effective with fortified foods and supplements, such as 5-MTHF/folate and folic acid. In fact, in the last decades, the main form of folate supplementation has been FA. Prescription of FA to women in the preconception period ...
How robust is the evidence on folic acid supplementation?
Penny cited the following
7 peer-reviewed research articles
7 professionally-backed sources
Overview
The evidence supporting folic acid supplementation for the prevention of neural tube defects (NTDs) in pregnancy is considered extremely robust. This conclusion is based on decades of research, including large randomized controlled trials, systematic reviews, and ongoing recommendations from major health organizations.
Key Points
Strength of Evidence for Neural Tube Defect Prevention
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Convincing and Consistent Results:
Multiple large-scale randomized controlled trials and systematic reviews have shown that taking 400–800 micrograms (mcg) of folic acid daily before conception and during early pregnancy reduces the risk of NTDs (such as spina bifida and anencephaly) by at least 50% or more.1ArticleRecommendation: Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication | United States Preventive Services TaskforceNearly half of all pregnancies ... of food suggests that an over-the-counter multivitamin with between 0.4 mg (400 μg) (the generally available dose) and 0.8 mg (800 μg) of folic acid daily reduces the risk for neural tube defects.10,12 Clinical practice guidelines ...→uspreventiveservicestaskforce.org
2ArticleFolic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement - PubMedImportance: Neural tube defects ... 3000 pregnancies affected each year. Many of these neural tube defects are caused by low folate levels in the body. Objective: The US Preventive Services Task Force (USPSTF) commissioned a reaffirmation evidence update on the benefits and harms of folicacidsupplementation...→PubMed
3ArticleTask Force Recommends Folic Acid to Prevent Neural Tube Defects | Patient CareBecause NTDs happen early in pregnancy, ... to help prevent NTDs. ... The updated recommendation statement reaffirms the task force’s January 2017 statement on the topic, which also had an “A” grade. After conducting an evidence review that included results from a handful of new studies, the task force said there was convincing evidence that supplements containing 0.4 to 0.8 mg of folicacid, taken during the periconceptional period, reduce the risk for neuraltubedefects...→American Academy of Family Physicians
4ArticleFolic Acid Supplementation for the Prevention of Neural Tube Defects: Recommendation Statement | AAFPWomen who have a personal or family history of a pregnancy affected by a neural tube defect are at increased risk of having an affected pregnancy. However, most cases occur in the absence of any personal or family history. The USPSTF found convincing evidencethatfolicacidsupplementation in the ...→5ArticleFinal Recommendation Statement: Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication | United States Preventive Services TaskforceIn 2017, the USPSTF reviewed the evidence on the benefits of folicacid supplementation to preventneuraltubedefects and found convincing evidence that the benefits of supplementation were significant. Three fair-quality observational studies (reported in 4 publications) published since the ...→6ArticleAbout Folic Acid | Folic Acid | CDCFolicacid is a form of folate that is used in supplements (vitamins) and fortified foods, such as breakfast cereals. Keep Reading FolicAcid: Sources and Recommended Intake · If you could become pregnant, the U.S. Public Health Service recommends that you get 400 mcg of folicacid daily to help prevent NTDs.1 · In addition, this recommendation is supported by the Institute of Medicine and the US Preventive Services Task Force. If you had a previous pregnancy ...→7ArticleFolic Acid for the Prevention of Neural Tube Defects: Recommendation Statement | AAFPAlthough a personal or family history ... an affected pregnancy, most cases occur in the absence of any positive history. Benefits of preventive medication. The USPSTF found convincing evidencethatsupplements containing 0.4 to 0.8 mg (400 to 800 mcg) of folicacid in the ...→8ArticleFolic Acid for the Prevention of Neural Tube Defects | Pediatrics | American Academy of PediatricsThe American Academy of Pediatrics endorses the US Public Health Service (USPHS) recommendation that all women capable of becoming pregnant consume 400 μg of folicacid daily to preventneuraltubedefects (NTDs). Studies have demonstrated that periconceptional folicacid supplementation can ...→American Academy of Pediatrics Publications
9ArticleFolic Acid Supplementation for the Prevention of Neural Tube Defects: US Preventive Services Task Force Recommendation Statement - PubMedThe USPSTF recommends that all women who are planning or capable of pregnancy take a daily supplement containing 0.4 to 0.8 mg (400-800 µg) offolicacid. (A recommendation).→ -
Global Health Guidelines:
The U.S. Preventive Services Task Force (USPSTF), World Health Organization (WHO), and other major health authorities give an “A” grade (highest certainty and benefit) to the recommendation that all people who could become pregnant take a daily folic acid supplement.1ArticleRecommendation: Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication | United States Preventive Services TaskforceNearly half of all pregnancies ... of food suggests that an over-the-counter multivitamin with between 0.4 mg (400 μg) (the generally available dose) and 0.8 mg (800 μg) of folic acid daily reduces the risk for neural tube defects.10,12 Clinical practice guidelines ...→2ArticleFolic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement - PubMedImportance: Neural tube defects ... 3000 pregnancies affected each year. Many of these neural tube defects are caused by low folate levels in the body. Objective: The US Preventive Services Task Force (USPSTF) commissioned a reaffirmation evidence update on the benefits and harms of folicacidsupplementation...→3ArticleTask Force Recommends Folic Acid to Prevent Neural Tube Defects | Patient CareBecause NTDs happen early in pregnancy, ... to help prevent NTDs. ... The updated recommendation statement reaffirms the task force’s January 2017 statement on the topic, which also had an “A” grade. After conducting an evidence review that included results from a handful of new studies, the task force said there was convincing evidence that supplements containing 0.4 to 0.8 mg of folicacid, taken during the periconceptional period, reduce the risk for neuraltubedefects...→4ArticleFolic Acid Supplementation for the Prevention of Neural Tube Defects: Recommendation Statement | AAFPWomen who have a personal or family history of a pregnancy affected by a neural tube defect are at increased risk of having an affected pregnancy. However, most cases occur in the absence of any personal or family history. The USPSTF found convincing evidencethatfolicacidsupplementation in the ...→5ArticleFinal Recommendation Statement: Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication | United States Preventive Services TaskforceIn 2017, the USPSTF reviewed the evidence on the benefits of folicacid supplementation to preventneuraltubedefects and found convincing evidence that the benefits of supplementation were significant. Three fair-quality observational studies (reported in 4 publications) published since the ...→7ArticleFolic Acid for the Prevention of Neural Tube Defects: Recommendation Statement | AAFPAlthough a personal or family history ... an affected pregnancy, most cases occur in the absence of any positive history. Benefits of preventive medication. The USPSTF found convincing evidencethatsupplements containing 0.4 to 0.8 mg (400 to 800 mcg) of folicacid in the ...→10ArticleDaily iron and folic acid supplementation during pregnancyDeficiencies in iron and folicacidduringpregnancy can potentially negatively impact the health of the mother, her pregnancy, as well as fetal development. Evidence has shown that the use of iron and folicacidsupplements is associated with a reduced risk of iron deficiency and anaemia in ...→who.int
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Population Impact:
Countries that have implemented folic acid supplementation and food fortification have seen significant declines in the rates of NTDs.8ArticleFolic Acid for the Prevention of Neural Tube Defects | Pediatrics | American Academy of PediatricsThe American Academy of Pediatrics endorses the US Public Health Service (USPHS) recommendation that all women capable of becoming pregnant consume 400 μg of folicacid daily to preventneuraltubedefects (NTDs). Studies have demonstrated that periconceptional folicacid supplementation can ...→
Evidence for Other Pregnancy Outcomes
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Other Outcomes Less Clear:
While folic acid is essential for maternal health and fetal development, evidence for benefits beyond NTD prevention—such as reducing the risk of preterm birth, low birth weight, or preeclampsia—is less consistent or conclusive. Some studies and meta-analyses suggest possible benefits, but results are mixed and not as robust as for NTD prevention.10ArticleDaily iron and folic acid supplementation during pregnancyDeficiencies in iron and folicacidduringpregnancy can potentially negatively impact the health of the mother, her pregnancy, as well as fetal development. Evidence has shown that the use of iron and folicacidsupplements is associated with a reduced risk of iron deficiency and anaemia in ...→11ArticleFolic acid supplementation during pregnancy for maternal health and pregnancy outcomes - PMCA review on folic acid supplementation during pregnancy by Charles et al (Charles 2005b) that included results from large randomised controlled trials found no conclusive evidence of benefit for folic acid supplementation in pregnant women.→12ArticleEffect of folate intake on health outcomes in pregnancy: a systematic review and meta-analysis on birth weight, placental weight and length of gestation - PMCOur aims were to systematically review randomizedcontrolledtrials (RCTs) investigating the effect of folate supplementation on birth weight, placental weight and length of gestation and to assess the dose–response relationship between folate intake (folicacid plus dietary folate) and health outcomes. The MEDLINE, EMBASE and Cochrane Library CENTRAL databases were searched from inception to February 2010 for RCTs in which folate intake and health outcomes in pregnancy ...→13ArticleSupplementation of folic acid in pregnancy and the risk of preeclampsia and gestational hypertension: a meta-analysis - PMCIn total, 13 cohort studies and 1 randomizedcontrolledtrial study was included, containing 160,562 and 149,320 women with and without folicacidsupplementationduringpregnancy. Pooled results showed that risk of gestational hypertension was not associated with the supplementationoffolicacid.→14ArticleFolic acid supplementation in pregnancy to prevent preterm birth: a systematic review and meta-analysis of randomized controlled trials - PubMedThe aim of this systematic review ... of folicacidsupplementationduringpregnancy to prevent preterm birth (PTB). The research protocol was designed a priori, defining methods for searching the literature in electronic databases, including and examining articles, and extracting and analyzing data. We included all randomizedtrials (RCTs) of asymptomatic singleton gestations without prior PTB who were randomized to prophylactic treatment with either FA supplementationorcontrol (placebo or ...→
Safety and Harms
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Safety Profile:
Folic acid supplementation at recommended doses (400–800 mcg daily) is not associated with serious harms to the mother or baby. High-quality studies have found no increased risk of autism, cancer, or other major adverse effects at these doses.1ArticleRecommendation: Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication | United States Preventive Services TaskforceNearly half of all pregnancies ... of food suggests that an over-the-counter multivitamin with between 0.4 mg (400 μg) (the generally available dose) and 0.8 mg (800 μg) of folic acid daily reduces the risk for neural tube defects.10,12 Clinical practice guidelines ...→3ArticleTask Force Recommends Folic Acid to Prevent Neural Tube Defects | Patient CareBecause NTDs happen early in pregnancy, ... to help prevent NTDs. ... The updated recommendation statement reaffirms the task force’s January 2017 statement on the topic, which also had an “A” grade. After conducting an evidence review that included results from a handful of new studies, the task force said there was convincing evidence that supplements containing 0.4 to 0.8 mg of folicacid, taken during the periconceptional period, reduce the risk for neuraltubedefects...→4ArticleFolic Acid Supplementation for the Prevention of Neural Tube Defects: Recommendation Statement | AAFPWomen who have a personal or family history of a pregnancy affected by a neural tube defect are at increased risk of having an affected pregnancy. However, most cases occur in the absence of any personal or family history. The USPSTF found convincing evidencethatfolicacidsupplementation in the ...→5ArticleFinal Recommendation Statement: Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication | United States Preventive Services TaskforceIn 2017, the USPSTF reviewed the evidence on the benefits of folicacid supplementation to preventneuraltubedefects and found convincing evidence that the benefits of supplementation were significant. Three fair-quality observational studies (reported in 4 publications) published since the ...→
Limitations and Research Gaps
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Beyond NTDs:
There is inadequate evidence to support benefits of folic acid supplementation for outcomes other than NTD prevention, and more research is needed in these areas.4ArticleFolic Acid Supplementation for the Prevention of Neural Tube Defects: Recommendation Statement | AAFPWomen who have a personal or family history of a pregnancy affected by a neural tube defect are at increased risk of having an affected pregnancy. However, most cases occur in the absence of any personal or family history. The USPSTF found convincing evidencethatfolicacidsupplementation in the ...→10ArticleDaily iron and folic acid supplementation during pregnancyDeficiencies in iron and folicacidduringpregnancy can potentially negatively impact the health of the mother, her pregnancy, as well as fetal development. Evidence has shown that the use of iron and folicacidsupplements is associated with a reduced risk of iron deficiency and anaemia in ...→11ArticleFolic acid supplementation during pregnancy for maternal health and pregnancy outcomes - PMCA review on folic acid supplementation during pregnancy by Charles et al (Charles 2005b) that included results from large randomised controlled trials found no conclusive evidence of benefit for folic acid supplementation in pregnant women.→12ArticleEffect of folate intake on health outcomes in pregnancy: a systematic review and meta-analysis on birth weight, placental weight and length of gestation - PMCOur aims were to systematically review randomizedcontrolledtrials (RCTs) investigating the effect of folate supplementation on birth weight, placental weight and length of gestation and to assess the dose–response relationship between folate intake (folicacid plus dietary folate) and health outcomes. The MEDLINE, EMBASE and Cochrane Library CENTRAL databases were searched from inception to February 2010 for RCTs in which folate intake and health outcomes in pregnancy ...→14ArticleFolic acid supplementation in pregnancy to prevent preterm birth: a systematic review and meta-analysis of randomized controlled trials - PubMedThe aim of this systematic review ... of folicacidsupplementationduringpregnancy to prevent preterm birth (PTB). The research protocol was designed a priori, defining methods for searching the literature in electronic databases, including and examining articles, and extracting and analyzing data. We included all randomizedtrials (RCTs) of asymptomatic singleton gestations without prior PTB who were randomized to prophylactic treatment with either FA supplementationorcontrol (placebo or ...→ -
Optimal Dose and Timing:
Most evidence supports starting supplementation at least one month before conception and continuing through the first trimester. There is less clarity about benefits of continuing supplementation later in pregnancy for other outcomes.4ArticleFolic Acid Supplementation for the Prevention of Neural Tube Defects: Recommendation Statement | AAFPWomen who have a personal or family history of a pregnancy affected by a neural tube defect are at increased risk of having an affected pregnancy. However, most cases occur in the absence of any personal or family history. The USPSTF found convincing evidencethatfolicacidsupplementation in the ...→7ArticleFolic Acid for the Prevention of Neural Tube Defects: Recommendation Statement | AAFPAlthough a personal or family history ... an affected pregnancy, most cases occur in the absence of any positive history. Benefits of preventive medication. The USPSTF found convincing evidencethatsupplements containing 0.4 to 0.8 mg (400 to 800 mcg) of folicacid in the ...→
Summary
- The evidence that folic acid supplementation prevents neural tube defects is extremely strong, consistent, and forms the basis for global health recommendations.
- The benefit is greatest when supplementation starts before conception and continues through the first trimester.
- Folic acid supplementation is safe at recommended doses, and no serious harms have been identified.
- Evidence for benefits beyond NTD prevention is less robust and remains an area for further research.
1
Article
Recommendation: Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication | United States Preventive Services Taskforce
Nearly half of all pregnancies ... of food suggests that an over-the-counter multivitamin with between 0.4 mg (400 μg) (the generally available dose) and 0.8 mg (800 μg) of folic acid daily reduces the risk for neural tube defects.10,12 Clinical practice guidelines ...
2
Article
Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement - PubMed
Importance: Neural tube defects ... 3000 pregnancies affected each year. Many of these neural tube defects are caused by low folate levels in the body. Objective: The US Preventive Services Task Force (USPSTF) commissioned a reaffirmation evidence update on the benefits and harms of folicacidsupplementation...
3
Article
Task Force Recommends Folic Acid to Prevent Neural Tube Defects | Patient Care
Because NTDs happen early in pregnancy, ... to help prevent NTDs. ... The updated recommendation statement reaffirms the task force’s January 2017 statement on the topic, which also had an “A” grade. After conducting an evidence review that included results from a handful of new studies, the task force said there was convincing evidence that supplements containing 0.4 to 0.8 mg of folicacid, taken during the periconceptional period, reduce the risk for neuraltubedefects...
4
Article
Folic Acid Supplementation for the Prevention of Neural Tube Defects: Recommendation Statement | AAFP
Women who have a personal or family history of a pregnancy affected by a neural tube defect are at increased risk of having an affected pregnancy. However, most cases occur in the absence of any personal or family history. The USPSTF found convincing evidencethatfolicacidsupplementation in the ...
5
Article
Final Recommendation Statement: Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication | United States Preventive Services Taskforce
In 2017, the USPSTF reviewed the evidence on the benefits of folicacid supplementation to preventneuraltubedefects and found convincing evidence that the benefits of supplementation were significant. Three fair-quality observational studies (reported in 4 publications) published since the ...
6
Article
About Folic Acid | Folic Acid | CDC
Folicacid is a form of folate that is used in supplements (vitamins) and fortified foods, such as breakfast cereals. Keep Reading FolicAcid: Sources and Recommended Intake · If you could become pregnant, the U.S. Public Health Service recommends that you get 400 mcg of folicacid daily to help prevent NTDs.1 · In addition, this recommendation is supported by the Institute of Medicine and the US Preventive Services Task Force. If you had a previous pregnancy ...
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Folic Acid for the Prevention of Neural Tube Defects: Recommendation Statement | AAFP
Although a personal or family history ... an affected pregnancy, most cases occur in the absence of any positive history. Benefits of preventive medication. The USPSTF found convincing evidencethatsupplements containing 0.4 to 0.8 mg (400 to 800 mcg) of folicacid in the ...
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Folic Acid for the Prevention of Neural Tube Defects | Pediatrics | American Academy of Pediatrics
The American Academy of Pediatrics endorses the US Public Health Service (USPHS) recommendation that all women capable of becoming pregnant consume 400 μg of folicacid daily to preventneuraltubedefects (NTDs). Studies have demonstrated that periconceptional folicacid supplementation can ...
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Folic Acid Supplementation for the Prevention of Neural Tube Defects: US Preventive Services Task Force Recommendation Statement - PubMed
The USPSTF recommends that all women who are planning or capable of pregnancy take a daily supplement containing 0.4 to 0.8 mg (400-800 µg) offolicacid. (A recommendation).
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Daily iron and folic acid supplementation during pregnancy
Deficiencies in iron and folicacidduringpregnancy can potentially negatively impact the health of the mother, her pregnancy, as well as fetal development. Evidence has shown that the use of iron and folicacidsupplements is associated with a reduced risk of iron deficiency and anaemia in ...