Folic acid/folate in pregnancy | Health Navigator NZ

Folic acid, sometimes called folate, is a vitamin that belongs to the vitamin B group. Your body needs folic acid when cells are growing and dividing very quickly, which happens during pregnancy.

On this page, you can find the following information:

What are folate and folic acid?
What are the benefits of folic acid in pregnancy?
How much folic acid should I take?
When should I start taking folic acid?

What are folate and folic acid?

Folate: is an essential B vitamin. It is found in leafy vegetables, citrus fruits, wholemeal bread, yeast, liver and legumes.

Folic acid: is the synthetic (‘man made’) form of folate. Folic acid is used in dietary supplements and fortified foods and drinks. It is more easily absorbed and used in your body, and more stable, than folate found in food.

What are the benefits of folic acid in pregnancy?

Early in pregnancy, when the foetus is developing, folic acid plays an important role in the development of the neural tube. As the foetus grows, the neural tube develops into the brain and spinal cord.

Sometimes an abnormality occurs when the neural tube does not close properly. This causes conditions known as neural tube defects (NTDs).

Neural tube defects happens in about 1 in 500 babies.
Some examples of neural tube defects are spina bifida, where the spine or its covering sticks out of the back, and anencephaly, in which the brain does not form properly.
Babies born with these defects often die, or have problems with walking and bowel and bladder control. Read more about neural tube defects.

Research shows that women who have a high level of folic acid before they become pregnant are less likely to give birth to a baby with NTDs. Folic acid supplementation can prevent up to 70 per cent of these defects.

How much folic acid should I take?

During your pregnancy, you should eat plenty of the foods that have folate in them, such as leafy green vegetables, wholegrain breads and cereals. However, you will not get enough folate from food to prevent NTDs.

The only way to be sure you're getting the right amount of folic acid during pregnancy is by taking a supplement.

In New Zealand, there are two funded strengths of folic acid tablets:

800 microgram
5 milligram.

Some dietary supplements and multivitamins have small amounts of folic acid, but it may not be enough for you.

For women who do not have high risk factors, the usual dose of folic acid for the prevention of NTDs is 800 micrograms once a day. Read more about folic acid tablets.

High-risk pregnancies

Some women are at increased risk of having a baby with a spinal cord problem. These women need higher doses of folic acid: 5 milligrams once a day.

You are at higher risk if:

you have had a previous pregnancy affected by a neural tube defect
you or your partner have a spinal cord defect
your or your partner have family members with a spinal cord defect
you are taking medication that is known to affect folate metabolism, such as medicine for epilepsy (eg, carbamazepine, sodium valproate)
you are on insulin treatment for diabetes
you are obese, that is, if your body mass index (BMI) is 30 or more
you have coeliac disease, diabetes, sickle cell anaemia or thalassaemia.

If you are planning to get pregnant, be sure to get enough folate to reduce the risk of these serious conditions for your baby.

When should I start taking folic acid?

Try starting folic acid daily while you are planning to become pregnant and continue through to 12 weeks after becoming pregnant. Your baby's spine develops during this first trimester.

If you find out you are pregnant and haven’t been taking a folic acid tablet, start taking tablets straight away.