Further education needed regarding folic acid and birth defects.




Journal of Nutrition

Related Monographs

Consumer Data: Folic Acid
Professional Data: Folic Acid


Folic acid is a member of the water-soluble B vitamin group. Isolated in 1946 from spinach leaves, its name comes from folium, the Latin word for leaf. In the body, folic acid is converted to a more biologically active form. Folic acid occurs in a wide variety of foods. Best sources include dark green leafy vegetables, brewer's yeast, liver and eggs. Other good sources are beets, broccoli, brussel sprouts, orange juice, cabbage, cauliflower, cantaloupe, kidney and lima beans, wheat germ, and whole grain cereals and breads. The body's "friendly" intestinal bacteria also produce folic acid.

In women, folic acid is crucial for closure of the fetus' neural tube during pregnancy. This makes adequate folic acid levels essential for preventing neural tube birth defects such as spina bifida.1 In general, pregnancy doubles a woman's requirements for folic acid.

While it has long been known that folic acid is an important nutrient, it has only been in the past thirty years or so that the role of folic acid in pregnancy has been evaluated. To date, we know that use of folic acid during pregnancy can eliminate the chance of the fetus developing neural tube defects because this nutrient is responsible for closing the neural tube. This valuable information has made folic acid supplementation during pregnancy a standard part of the education and treatment process.

A recent study conducted at Midwestern University stated that it is imperative that pharmacists and health care professionals inform women of the importance of folic acid in pregnancy, since many women are unaware of adequate folic acid consumption. In their final year of education, future pharmacists were assessed on their knowledge the role of folic acid. This 3-year study enrolled 98 students to take a short survey concerning birth defects and folic acid. Over 93% of the students knew that folic acid could prevent birth defects and 73% knew that supplementation should be initiated before pregnancy. However, a smaller amount of students knew what dosage should be taken or what sources contained sufficient amounts of folic acid. The authors concluded, "these results show that although student (future) pharmacists are aware of folic acid's ability to prevent birth defects, many lack the specific knowledge needed to effectively counsel women in future clinical practice."2


1. Steegers-Theunissen RP. Folate Metabolism and Neural Tube Defects: A Review. Eur J Obstet Gynecol Reprod Biol. Jul1995;61(1):39-48.
2. Lynch SM. Assessment of student pharmacists' knowledge concerning folic acid and prevention of birth defects demonstrates a need for further education. J Nutr. 2002 Mar;132(3):439-42.