Keywords
recommendations
birth defects
pregnancy
supplementation
Abstract
FOLIC ACID – ROLE IN THE BODY, RECOMMENDATIONS AND CLINICAL SIGNIFICANCE
Introduction. Folic acid is a compound classified as B group vitamins. In the body it is subject to processes that transfer its inactive form into a form responsible for biological effects of folic acid, i.e. 5-methyltetrahydrofolate (5-MTHF). It is, in particular, responsible for processes of the correct biosynthesis of purine and pyridine bases present in the formation of DNA and RNA molecules. Humans do not synthesize the endogenous form of folic acid; therefore, it is vital to supplement this vitamin in its natural form or multivitamin preparations. The most folic acid is found in the green leafy vegetables (spinach, peas, asparagus) and in offal (liver). An adequate supply of folic acid is especially indicated in pregnant women with a reduced amount of folic acid due to its use by an intensively developing foetus. The recommended dose of folic acid during this period is 0.4 mg/24h and this dose varies depending on the patient’s and her family’s medical history. The updated state of knowledge on the role of vitamin B9 in the body has been presented. The importance of its supplementation in specific clinical cases was analyzed.
Summary. Many studies indicate an important role of the folic acid in the prevention of congenital defects of the nervous, cardiovascular and urogenital systems. Its deficiency increases the risk of complications in pregnancy, such as recurrent miscarriages, pre-eclampsia or postpartum haemorrhage. For this reason, a prophylactic folic acid supplementation is recommended, in women with increased risk of its deficiency, in particular.
References
1. Cieślik E., Kościej A. Kwas foliowy – występowanie i znaczenie. Probl Hig Epidemiol. 2012; 93(1): 1–7.
2. Bomba-Opoń D, Hirnle L, Kalinka Ji wsp. Suplementacja folianów w okresie przedkoncepcyjnym, w ciąży i połogu. Rekomendacje Polskiego Towarzystwa Ginekologów i Położników. Gin Perinat Prakt. 2017; 2, 5: 210–214.
3. Paul L, Selhub J. Interaction between excess folate and low vitamin B12 status. Mol Aspects Med. 2017; 53: 43–47.
4. National Institutes of Health. Office of Dietary Supplemensts. Folate. Fact Sheet for Health Professionals. https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/. Dostęp: 25.02.2019.
5. Kerr SM, Parker SE, Mitchell AA et al. Periconceptional maternal fever, folic acid intake, and the risk for neural tube defects. Ann Epidemiol. 2017: 27(12); 777–782.
6. Putta S, Pennell PB. Management of epilepsy during pregnancy: evidence–based strategies. Future Neurol. 2015; 10 (2): 161–176.
7. Viale L, Allotey J, Cheong-See F et al. Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis. Lancet. 2015; 386(10006):1845–1852.
8. Gooneratne I.K, Wimalaratna M, Ranaweera AKP et al. Contraception advice for women with epilepsy. BMJ. 2017; 357:j2010.
9. Van Gool JD, Hirche H, Lax H et al. Folic acid and primary prevention of neural tube defects: A review. Reprod Toxicol. 2018; 80:73–84.
10. Turgal M, Gumruk F, Karaagaoglu E et al. Methylenetetrahydrofolate Reductase Polymorphisms and Pregnancy Outcome. Geburtshilfe Frauenheilkde. 2018: 78(09); 871–878.
11. Servy EJ, Jacquesson-Fournols L, Cohen M et al.MTHFR isoform carriers. 5-MTHF (5-methyl tetrahydrofolate) vs folic acid: a key to pregnancy outcome: a case series. J Assist Reprod Genet. 2018: 35(8); 1431–1435.
12. Whitrow MJ., Moore VM., Rumbold AR. et al. Effect of Supplemental Folic Acid in Pregnancy on Childhood Asthma: A Prospective Birth Cohort Study. Am J Epidemiol. 2009; 170(12): 1486–1493.
13. Trivedi MK., Sharma S., Rifas-Shiman SL. Et al. Folic Acid in Pregnancy and Childhood Asthma: A US Cohort. Clin Pediatr. 2018; 57(4): 421–427.
14. Vereen S., Gebretsadik T., Johnson N. Association Between Maternal 2nd Trimester Plasma Folate Levels and Infant Bronchiolitis. Matern Child Health J. 2018; 23(2):164–172.
15. Imbard A, Benoist JF, Blom H. Neural Tube Defects, Folic Acid and Methylation. Int J Environ Res Public Health. 2013: 10(9); 4352–4389.
16. Greene NDE, Copp AJ. Neural Tube Defects. Annu Rev Neurosci. 2014: 37(1); 221–242.
17. Bagłaj M. Wady dysraficzne: wielospecjalistyczne postępowanie. Stowarzyszenie na Rzecz Dzieci z Rzadkimi Chorobami Genetycznymi i Ich Rodzin Wspólnie. http://wspolnie.org/wady-dysraficzne/. Dostęp: 25.02.2019.
18. Liu S, Joseph KS, Luo W et al. Effect of Folic Acid Food Fortification in Canada on Congenital Heart Disease Subtypes Clinical Perspective. Circulation. 2016: 134(9); 647–655.
19. Linask KK, Huhta J. Folate protection from congenital heart defects linked with canonical Wnt signaling and epigenetics. Curr Opin Pediatr. 2010: 22(5); 561–566.
20. Van Beynum IM, Kapusta L, Bakker MK et al. Protective effect of periconceptional folic acid supplements on the risk of congenital heart defects: a registry–based case–control study in the northern Netherlands. Eur Heart J. 2009: 31(4); 464–471.
21. Groen in’t Woud S, Renkema KY, Schreuder MF et al. Maternal risk factors involved in specific congenital anomalies of the kidney and urinary tract: A case–control study. Birth Defects Res A Clin Mol Teratol. 2016: 106(7);596–603.
22. Canfield MA, Collins JS, Botto LD et al. Changes in the birth prevalence of selected birth defects after grain fortification wiht folic acid in the United States: Findings from a multi-state population–based study. Birth Defects Res A Clin Mol Teratol. 2005: 73(10); 679–689.
23. Godwin KA., Sibbald B., Bedard T et al. Changes in Frequencies of Select Congenital Anomalies since the Onset of Folic Acid Fortification in a Canadian Birth Defect Registry. Can J Public Health. 2008;99(4):271-5.
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