Effects of Maternal Folic Acid Supplementation on the Development of Neural Tube and Cardiovascular System of the off springs in Human and Animal Models
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Date
2014-06
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Addis Abeba University
Abstract
Folate is a water-soluble vitamin B present in legumes (e.g. beans, peas and lentils), leafy
green vegetables (e.g. spinach and asparagus), liver and certain fruits (e.g. banana,
cantaloupe and strawberry). Folic acid supplementation to pregnant women had no acute
and long-term adverse effects on the health status of mothers as well as the new born infants.
Maternal folic acid supplementation had no significant association with multiple births.
Maternal folic acid supplementation had a protective effect for neural tube defects (NTDs)
especially spina bifida and anencephaly. Concomitant administration of maternal folic acid
and methionine may also prevent retinoic acid induced cleft palate than use of folic acid
alone. Maternal obesity before pregnancy with body mass index (BMI) ≥30 kg/m2 was
significantly associated with an approximately two fold increased risk of NTDs in offspring.
The NTD protective association of folic acid was also stronger in overweight/ obese women
BMI ≥ 25 kg/m2 than in normal/underweight women BMI < 25 kg/m2. Food fortification with
folic or maternal supplementation of folic acid may have a protective effect for coarctation of
aorta and left ventricular outflow tract obstruction, but no significant association was
observed for tetralogy of Fallot and d-transposition of the great arteries.
High doses of daily maternal folate supplementation (50 mg/kg/day) during embryonic/fetal
development are necessary for early post-implantation embryonic viability, chorioallantoic
fusion, hematopoiesis, and the development of neural tube and heart. Maternal
supplementation of multivitamin containing folic acid had more effective in preventing NTDs
and congenital heart defects (CHDs) than use of folic acid alone, if it starts two months
before conception and continues until completion of the second month of pregnancy and the
frequency should be higher than five times per week. Use of vegetable and fruit during
pregnancy also has a beneficial effect in preventing NTDs.
Despite the protective effect of folic acid in NTDs by facilitating the neural tube closure,
additional investigation is required to understand the exact mechanism of action of folic acid
in neural tube.
Key words: folic acid; maternal; supplementation; NTDs; CHDs
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Keywords
Folic Acid; Maternal; Supplementation; NTDs; CHDs