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Folic acid is a vitamin. It is vitamin B9 (also known as "folate" or "folacin"). Its main role is to help form the DNA molecule. It also acts on protein synthesis and the multiplication of blood, nerve, and immune cells. Its action is therefore very important during periods of high metabolic activity, such as childhood, adolescence, and especially pregnancy.
Vitamin B9 is not produced by the body and must therefore be provided by the diet. Liver, yeast, egg yolks, pasta, green vegetables, pulses, fruit, and soya are particularly rich in folic acid.
It would appear that consuming folic acid before pregnancy helps you to get pregnant by increasing female fertility. In fact, as in all the other cells making up the body, folic acid plays an active role in the synthesis of the oocyte's DNA molecule. Vitamin B9, therefore, improves oocyte quality. It is also thought to be involved in embryonic development and to increase embryo implantation rates in the endometrium.
Vitamin B9, therefore, plays an essential role when it comes to conceiving a child. It is therefore recommended that folic acid supplementation (consumption of vitamin B9-rich products and/or food supplements) should be started at least three months before becoming pregnant and continued during pregnancy, up to the twelfth week of amenorrhoea.
75% of women of childbearing age suffer from moderate vitamin B9 deficiency due to inadequate dietary intake. 7% have a severe deficiency.
Vitamin B9 is also thought to have a beneficial effect on spermatogenesis. As in women, folic acid is involved in the formation of the DNA of the male gamete: the spermatozoon. A diet rich in folic acid in men is associated with an increase in the quantity and mobility of spermatozoa and a reduction in morphological abnormalities. In men, too, folic acid boosts male fertility and helps in the conception of a child.
A woman's body changes throughout pregnancy. From the very first days, changes take place, and energy requirements increase. Folic acid helps to adapt the mother's body to pregnancy.
Vitamin B9 helps combat the risk of anaemia, which is very common during pregnancy. It also helps reduce fatigue and mood disorders. It modulates the mother's immune response to the embryo and promotes the development of organs such as the uterus and mammary glands.
Taking folic acid during pregnancy also ensures that the pregnancy runs smoothly until term. More specifically, a deficiency can increase the risk of miscarriage and premature delivery. A folic acid deficiency is also thought to be one of the causes of intrauterine growth retardation.
In addition to its beneficial role in the pre-conception period and during pregnancy, folic acid plays a fundamental role in foetal development. More specifically, folic acid deficiency is associated with the appearance of neural tube defects. In pregnant women, vitamin B9 supplementation reduces the risk of the foetus developing certain congenital malformations of the nervous system.
Neural tube defects are congenital malformations of the brain, spinal cord, and spinal column. They occur during the 4th week of development.
Every year in Europe, 5,000 births are affected. These conditions, such as spina bifida and anencephaly, have serious consequences for the newborn.
Spina bifida means that the spinal column does not close. This means that the muscles, bones, nerves, and skin cannot develop properly. As a result, the spinal cord can be damaged. The consequences for the newborn are more or less severe depending on the location of the injury. This is the most common neural tube defect: its prevalence in the French population is 1/10,000.
Folic acid promotes foetal development by reducing the risk of neural tube defects by 75%!
In addition to these anomalies, the association between folic acid levels during pregnancy and heart, cleft lip and palate, and urinary tract malformations has been described. Folic acid supplementation can reduce the risk of these congenital malformations.
The official recommendations of the Ministry of Health are to prescribe folic acid for pregnancy to all women of childbearing age who wish to become pregnant. The prescription begins three months before becoming pregnant and must continue throughout the pregnancy, until the tenth week of pregnancy. The prescribed dose is 400 micrograms per day. However, in women who have already given birth to an infant with a neural tube closure anomaly, the prescribed dose is 5 milligrams per day.
Fabien Duval, Ph.D.
Reproductive and Developmental Biology