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Folic Acid in Obstetric Practice: A Review

Talaulikar, Vikram Sinai MD, MRCOG*; Arulkumaran, Sabaratnam MD, PhD, FRCS, FRCOG

Obstetrical & Gynecological Survey: April 2011 - Volume 66 - Issue 4 - p 240-247
doi: 10.1097/OGX.0b013e318223614c

Folic acid is one of the B complex vitamins and is now recognized as a major component of the periconceptional care of women in the reproductive age group. Deficiency of folic acid can lead to neural tube defects in the fetus and megaloblastic anemia in the mother. Due to its lower bioavailability from natural foods, many countries have adopted mandatory folic acid food fortification programs. Although these programs have been a public health triumph in reducing the burden of neural tube defects, there have been growing concerns about the role played by folic acid supplementation in the rising colon cancer rates over the past decade. The majority of the evidence available to date is reassuring, and until further long-term population as well as laboratory studies are completed, folic acid will continue to play a vital role in early pregnancy care. It is important for healthcare professionals to be aware of the recent evidence that has accumulated, suggesting higher folic acid requirements in certain groups of women and offer correct advice on the use of folic acid supplements. This review looks at some of the existing evidence on folic acid supplementation and summarizes the recommendations on the use of folic acid supplements by obstetricians, family physicians, and others providing prenatal care.

Target Audience: Obstetricians and Gynecologists, Family physicians

Learning Objectives: After completing this CME activity, physicians should be better able to evaluate the need for folic acid supplementation in various patient groups to lower the risk of neural tube defects due to folate deficiency; recommend common, natural and fortified food sources rich in folic acid; and distinguish the effects of folate deficiency in the mother and fetus.

*Clinical Research Fellow, †Head of Department, Department of Obstetrics and Gynaecology, St. George's Hospital, Tooting—London, United Kingdom

Chief Editor's Note: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA/PRA category 1 credits™ can be earned in 2011. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.

All authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations pertaining to this educational activity.

Correspondence requests to: Vikram Sinai Talaulikar, MD, MRCOG, Department of Obstetrics and Gynaecology, St. George's Hospital, Tooting—London, United Kingdom SW17 0QT. E-mail:

© 2011 by Lippincott Williams & Wilkins.