Health Literacy

Folic acid for a healthy baby.

Vitamins and minerals have important roles in maintaining our health. Each one provides its own special benefit to keep us healthy. Vitamin B9, also known as folic acid, is one of the B vitamins which helps the body make healthy new cells. Everyone needs folic acid throughout their life, however, this is especially important for women who may become pregnant.  

In 2009 the United States Preventive Services Task Force, USPSTF, Recommended that women of childbearing age take a supplement of 0.4mg-0.8mg daily. This recommendation was recently re-evaluated and the evidence showed a substantial benefit from supplementation for women who are planning or capable of pregnancy.

What does Folic acid have to do with pregnancy?

Folic acid plays a critical role in the development of the brain and spinal cord during pregnancy. These parts of the nervous system form very early; in fact 3 weeks after conception, the brain and spinal cord are developing. At this point in time many women are not even aware that they are pregnant, and insufficient amounts of available folic acid can lead to birth defects of the brain and spinal cord.

The critical time for folic acid supplementation starts 1 month prior to conception however, according to statistics, half of all pregnancies in the United States are unplanned. If women are taking a regular supplement of folic acid, it will be available during this critical time of development. Supplementation at this level provides health benefits to both the mother and the child throughout the pregnancy.

Folic acid is found in food sources including leafy green vegetables, fruits, dried beans, peas and nuts, and also enriched breads and cereals. Despite the availability from food sources, most women do not receive the recommended daily amount of folic acid from their diet alone.

There is currently no evidence suggesting any harm to mom or the baby from folic acid supplementation at this dosage.

Folic acid does provide other health benefits to our body, so even if a female never becomes pregnant, she can benefit from using this supplement.

Special circumstances

Take the time to discuss your individual situation with your healthcare provider. There are certain situations where these recommendations do not apply.  

  • Women who have had a previous pregnancy affected by brain or spinal cord defects
  • Those who have a family history of this type of birth defects  
  • Women who are using antiseizure medications  

A little bit of prevention may make a lifetime of difference.

Bottom Line

The US Preventive Services Task Force (USPSTF) concludes with high certainty that the benefits to the mother and infant from periconceptional folic acid supplementation taken at the usual doses (0.4 mg - 0.8 mg daily) for preventing neural tube defects is substantial (A recommendation). This recommendation does not apply to women who have had a previous pregnancy affected by neural tube defects or who are at high risk because of other factors (eg, family history or use of antiseizure medications). This updated recommendation is unchanged from the USPSTF 2009 recommendations on folic acid supplementation in women of childbearing age. (LOE = 2a)

In this review the USPSTF found adequate evidence from both clinical trials and observational studies, as well as from case control studies, of a substantial benefit of taking a daily supplement containing 0.4 mg to 0.8 mg folic acid for preventing neural tube defects in all women who are planning or capable of pregnancy. Most women do not receive the recommended daily intake of folate from diet alone. Half of all pregnancies in the United States are unplanned. Thus, the Task Force recommends that clinicians advise all women who are capable of pregnancy to take daily folic acid supplements. The critical period for supplementation starts at least 1 month prior to conception. There is currently no evidence suggesting any harm to the mother or infant from folic acid supplementation taken at the usual doses. The American Academy of Family Physicians, American College of Obstetricians and Gynecologists, American Academy of Pediatrics, and Centers for Disease Control all concur with recommending at least 0.4 mg folic acid daily for women who are capable of becoming pregnant.

Bibbins-Domingo K; US Preventive Services Task Force. Folic acid supplementation for the prevention of neural tube defects: US Preventive Services Task Force recommendation statement. JAMA 2017;317(2):183-189.

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