How much folate during pregnancy
Pro Research Analysisby 
Searched over 200M research papers
Recommended Folate Intake During Pregnancy
Importance of Folate During Pregnancy
Folate, a B-vitamin, is crucial during pregnancy for the synthesis and maintenance of DNA, which supports the growth and development of the fetus and the expansion of maternal blood volume and tissues2. Adequate folate intake is essential to prevent neural tube defects (NTDs) and other congenital anomalies9.
Recommended Dietary Allowance (RDA) for Folate
The Institute of Medicine recommends a dietary folate equivalent (DFE) intake of 600 micrograms per day for pregnant women. This recommendation is based on the amount needed to maintain normal red cell folate concentrations and prevent folate deficiency1. This intake level is derived from the estimated average requirement (EAR) of 520 micrograms per day, adjusted to meet the needs of nearly all pregnant women1.
Variability in Folate Recommendations
Nutrient intake values for folate during pregnancy vary widely across different countries. For instance, the United Kingdom recommends 300 micrograms per day, while Mexico recommends 750 micrograms per day2. This variation highlights the lack of a standardized global framework for establishing folate intake values.
Folate Supplementation
Many countries promote the use of folic acid supplements before and during pregnancy to meet the increased folate requirements. Studies have shown that a significant percentage of pregnant women do not achieve adequate folate intake through diet alone, necessitating supplementation3. For example, in Southern Italy, 65% of pregnant women reported inadequate folate intake, and 74.8% were classified as insufficient users of folic acid supplements3.
Impact of Supplementation Dosage
Research indicates that prenatal supplements containing 400 micrograms of folic acid per day are generally sufficient to meet the RDA. However, many over-the-counter prenatal vitamins contain higher doses, such as 800 micrograms per day. Studies have shown that higher doses lead to increased serum folate concentrations in maternal blood but do not significantly affect cord blood folate levels4 7. This suggests that while higher doses may benefit maternal folate status, they do not necessarily translate to higher fetal folate levels.
Folate Catabolism During Pregnancy
Pregnancy increases the rate of folate catabolism, leading to an additional dietary folate requirement of about 200-300 micrograms per day5. This increased breakdown necessitates higher folate intake to maintain adequate folate status.
Folate Intake and Maternal Health
Adequate folate intake is also linked to maternal health outcomes. For instance, lower red blood cell folate levels at the first prenatal visit are associated with a higher risk of postpartum anemia6. Therefore, continuous folate supplementation throughout pregnancy is recommended to support both maternal and fetal health.
Conclusion
In summary, the recommended folate intake for pregnant women is 600 micrograms per day, with supplementation often necessary to meet this requirement. While higher doses of folic acid in prenatal vitamins can enhance maternal folate status, they do not significantly impact fetal folate levels. Ensuring adequate folate intake is crucial for preventing congenital anomalies and supporting overall maternal and fetal health.
Sources and full results
Most relevant research papers on this topic
New standard for dietary folate intake in pregnant women.
The recommended dietary allowance for folate intake in pregnant women is 1362 nmol (600 microg) DFE/d, which is sufficient to maintain normal folate status and prevent deficiency in 97-98% of women.
Highly CitedNutrient Intake Values for Folate during Pregnancy and Lactation Vary Widely around the World
Countries' nutrient intake values for folate during pregnancy and lactation vary widely, with the recommended daily intake ranging from 300 g/day in the UK to 750 g/day in Mexico.
Rigorous JournalDietary Folate Intake and Folic Acid Supplements among Pregnant Women from Southern Italy: Evidence from the “Mamma & Bambino” Cohort
Pregnant women with inadequate folate intake and low folic acid supplement use are at higher risk of preterm birth and small for gestational age newborns.
Observational StudyRigorous JournalUnmetabolized Folic Acid Response to Folic Acid Supplementation Dose During Pregnancy
Higher doses of folic acid in over-the-counter prenatal vitamins lead to higher unmetabolized folate concentrations in maternal blood, but not in cord blood.
Accelerated folate breakdown in pregnancy
During pregnancy, pregnant women require 200-300 micrograms of dietary folate per day due to increased folate catabolism, a value significantly higher than recent recommendations.
Observational StudyHighly CitedMaternal anaemia and folate intake in early pregnancy
Women should start folate supplementation before pregnancy and continue it after the first trimester to prevent anaemia in the first trimester and beyond.
Observational StudyFolate and Choline Metabolite Changes in Maternal and Cord Blood in Response to Folic Acid Supplementation Dose During Pregnancy
Supplementing with the dose of folic acid commonly found in over-the-counter prenatal supplements during pregnancy had a similar impact on maternal folate concentrations at delivery as supplementing with the recommended amount, but increased serum folate and plasma choline in cord blood.
More than 50% of pregnant Japanese women with an intake of 150 μg dietary folate per 1,000 kcal can maintain values above the cut-off.
The estimated average requirement of folate for pregnant Japanese women is 250 g/d, with more than 50% maintaining values above the cut-off value.
Observational StudyWhat Dose of Folic Acid Should Be Used for Pregnant Diabetic Women?
Pregnant diabetic women should receive 0.4 mg/day of folic acid supplementation to reduce the risk of neural tube defects.
Very Rigorous Journal