Maternal Folic Acid Intake

A major issue being addressed is the impact of diet, more specifically folic acid intake, on the prevention of certain birth outcomes. Folic acids role as a protective factor for fetal growth and development throughout pregnancy has been known for over 50 years (Finnell et al, 2010) and has become a widely speculated and researched issue.

Folic acid is a B-group vitamin involved in cell growth and reproduction therefore its level of intake has a significant effect on the acquisition of neural tube defects and other birth outcomes. This vitamin, also known as folate, is unable to be synthesised by the body therefore must be attained through diet or vitamin supplements (Finnell et al, 2010). It can be found in the form of tetrahydrofolate which has a role in the formation of deoxythymidylate monophosphate and of methionine from homocysteine (Giesel, 2003). The deoxythymidylate monophosphate is a compound essential for DNA and RNA synthesis and is not able to be produced when there is a folate deficiency; without synthesis via this compound chromosomal abnormality can result in the fetus. The conversion of homocysteine to methionine also cannot occur when there is a folic acid deficiency, thus growth and development of the neural tube is affected resulting in defects (Giesel, 2003). Folic acids properties and role in biological processes make it essential in our diets to ensure healthy birth outcomes.

Neural tube defects that occur as a result of folic acid deficiency in mothers are most commonly spina bifida and anencephaly. Spina bifida is a malformation in the development of the spine which often results in paralysis (Green, 2002). Folic acid helps to prevent this malformation by ensuring that the spinal cord closes properly during the early stages of pregnancy. Whilst, anencephaly accounts for approximately 30% of all neural tube defects and is the result of underdevelopment of the brain and skull (Green, 2002). Children born with this fetal condition will most likely die within a short period of time before or after birth. These neural tube defects have a high incidence, although the chances of these birth defects can be decreased through a change in dietary behaviour and education amongst women of child bearing age.

Adequate intake of this nutrient can act as a protective factor against neural tube defects and in addition to this, research has also been conducted to determine its impact on other positive birth outcomes. Folic acid deficiency has been suggested to cause chromosomal abnormalities in the body, as it causes defects in chromosomal DNA which can lead to instability and breakage (Green, 2002). This suggested link between folic acid deficiencies and chromosomal defect can lead to birth defects, including Down syndrome. Consumption of recommended folic acid intake is believed to also have positive health outcomes, including the prevention of other birth defects such as facial clefts, cardiovascular anomalies and limb defects (Green, 2002). Therefore, the effects of low folic acid intake are not only linked to neural tube defects but also to other negative birth outcomes.

Birth defects often occur in the early stages of pregnancy, before the individual even knows that they are pregnant. This is specifically the case with neural tube defects as the structure which forms the brain and spinal cord closes within 28 days of conception (Williamson, 2001). Thus, the consumption of adequate folic acid intake is important in the diets of women who are sexually active or trying to become pregnant. According to the Public Health Service, the recommended daily intake of 0.4 milligrams is essential in reducing the incidence of neural tube defects as well as other conditions (Giesel, 2003). Folic acid is found in a variety of foods, although it is not always possible to obtain