Another Benefit of Pre-Conception Folic Acid

Women who take folic acid before conception significantly reduce the risk having a child who is small for gestational age, a new study found. The population-based study continues to support the recommendation that women of childbearing age should take a folic acid supplement.

Researchers reviewed 108,525 pregnancies in the United Kingdom and found that most of the women, at 84.9%, had taken folic acid during pregnancy. But they also discovered that just 25.5% of women took the supplements before conception.

Key Points:

- Taking folic acid prior to conception reduces the risk of giving birth to a baby who is small for gestational age.

- OB/GYNs and other women's health care providers should continue to encourage women of reproductive age to take folic acid supplements regardless of their pregnancy status.

Among women who started taking folic acid after learning they were pregnant, 13.8% of babies were born with a birth weight lower than the 10^th percentile. That’s compared with 9.9% of babies who were small for gestational age born of women who were already taking the supplement prior to becoming pregnant.

The benefit of taking folic acid prior to conception was reproduced when researchers looked at the tiniest babies. When comparing pre- and post-conceptual folic acid supplementation, the prevalence of birth weight under the 5^th percentile was 4.8% and 7.1%, respectively. Significant to the finding for the very smallest newborns, the researchers reported that post-conception folate supplementation had no significant effect on small for gestational age rates among babies weighing under the 5^th percentile.

"Increased uptake of folic acid prior to pregnancy and throughout the first trimester could have significant public health benefits given the poor outcomes associated with SGA babies,” said Khaled Ismail, professor of obstetrics and gynecology at the University of Birmingham, England, and coauthor of the study, in a news release. “New strategies are therefore vital to improve the lives of both mothers and babies."

The study was published online in BJOG: An International Journal of Obstetrics and Gynaecology late last month.