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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Addis Abeba University


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



Folic Acid; Maternal; Supplementation; NTDs; CHDs