Why Pregnant Women Are Avoiding Folic Acid Supplements

History of Folic Acid

In 1931, Dr. Lucy Wells, a British pathologist, went to Bombay to investigate macrocytic anemia in pregnancy, which was prevalent in female textile workers. She found that the anemia was most frequent in poorer populations with diets deficient in protein, fruit, and vegetables. This led Wills to study the effects of changes in diet on the macrocytic anemia of albino rats. She discovered that the anemia was prevented by yeast added to a diet otherwise lacking B vitamins

In 1941, folate was first isolated from spinach and received the name "folic acid." This was the same vitamin that was helpful in reversing anemia in those lab rats in Dr. Wells's study.

In 1943, folic acid was first chemically manufactured by Bob Stokstad (working at Lederle Laboratories American Cyanid Company) in Pearl River, New York. This synthetic form was different than the natural folate found in foods, however, in it's chemical structure. So at that point, "folic acid" became used to denote the fully oxidized chemical compound, not present in natural foods.

(Currently, the term "folate" is used to denote the large group of compounds possessing the same vitamin activity and includes natural folates and folic acid.)

In 1965, after many years of study, the relationship between apparent folate deficiency and NTD (neural tube defects) occurrence was hypothesized. The British Medical Research Council conducted a randomized control trial and found that women with a previous history of a pregnancy affected by NTD reduced their recurrence risk by 70% by taking 4000 micrograms (µg) of folic acid daily.

In 1991, the Centers for Disease Control (CDC) recommended that women with a history of a prior NTD-affected pregnancy should consume 4,000 micrograms of folic acid daily starting at the time they begin planning a pregnancy. The following year, the U.S. Public Health Service began recommending that all women of childbearing age consume 400 micrograms of folic acid daily through fortification, supplementation, and diet to prevent NTDs.

In 1998, the United States authorized mandatory fortification of enriched cereal grain products with folic acid. The U.S. program adds 140 µg of folic acid per 100 g of enriched cereal grain product and has been estimated to provide 100–200 µg of folic acid per day to women of childbearing age.

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