A 2009 study found that folic acid deficiency significantly raises the risk for preeclampsia in pregnant women. Preeclampsia is a serious condition that worsens over the duration of the pregnancy and is only cured by delivery. Fifteen percent of pre-term deliveries are due to preeclampsia. The likelihood of infant death is increased five-fold when preeclampsia is present.
Preeclampsia commonly occurs after 20 weeks gestation and is responsible for 18% of maternal deaths in the U.S. each year. Symptoms of preeclampsia include high blood pressure, swelling, rapid weight gain, headache and nausea as well as vision changes, breathing trouble, rapid pulse and lower back pain. A physician will typically diagnose preeclampsia due to the presence of protein in the urine.
Little is known about the causes of preeclampsia, however, it has been associated with restricted blood flow to the uterus, hormone imbalances, damaged blood vessels and preexisting chronic disease as well as high body fat, poor diet and deficiencies of vitamin D, calcium, magnesium, vitamin B6 and folic acid.
The association between a folic acid deficiency and preeclampsia was reported in a 2009 study in which pregnant women with preeclampsia were found to have significantly lower amounts of folic acid than non-preeclamptic women. Folic acid, along with vitamins B12 and B6 are responsible for the breaking down and proper assimilation of the amino acid homocysteine. Too much homocysteine in the blood has been shown to increase the risk of heart disease, stroke and vascular disease. The presence of high levels of homocysteine in the blood of a pregnant woman is thought to be the cause of the high blood pressure that is at the center of preeclampsia.
Women who are planning to become pregnant, or who are pregnant, are advised to take folic acid supplements in the early stages of their pregnancy to avoid serious congenital defects in their developing infant. That same folic acid supplement may protect mother and child later in the pregnancy from the serious effects of preeclampsia.
The full amount of folic acid needed for pregnant women and their developing infants are significant enough that it is not likely they will be obtained through diet alone. However, in addition to supplements good sources of folic acid are green leafy vegetables, oranges and folic acid fortified foods such as bread and breakfast cereals.
If you have any questions regarding folic acid supplementation please consult your physician.
Mahmoud, A., Elkattan, E. A., Eldaly, A. A., Omran, E. F., & Mandour, I. (2009) A comparative study of folate and vitamin B12 serum levels in preeclamptic versus normotensive pregnant women in correlation with uterine and umbilical artery Doppler findings and pregnancy outcome. Journal of Turkish-German Gynecology Association, 10, 152-157.
Williamson, C. (2006) Nutrition in pregnancy. Nutrition Bulletin, 31, 28-59.