Question

A 24-year-old patient is considering pregnancy in the next year. Her medical history and physical examination are normal. She is unaware of any significant family history. She exercises regularly and does not smoke or drink alcohol. She asks if her diet has adequate folate and what you recommend to your patients. Which of the following statements about folate is correct?

A. Folate supplementation is recommended for this patient
B. Most patients get an adequate intake by diet alone
C. She is not currently planning a pregnancy and does not need to worry about folate
D. Current grain supplementation adequately prevents neural tube defects
E. Folate does not need to be started until after a pregnancy is documented

Answer 1

Folate supplementation of at least 400 µg/day is recommended for women who might become pregnant to prevent neural tube defects. Adequate folate intake is essential early in pregnancy, often before pregnancy is confirmed, hence the need for preconception supplementation.

Step-by-step explanation:

The correct statement about folate is that folate supplementation is recommended for women who might become pregnant. The Food and Nutrition Board of the Institute of Medicine advises this because folate is essential for the prevention of neural tube defects (NTDs) such as spina bifida and anencephaly. These defects occur early in pregnancy, often before a woman knows she is pregnant, hence the recommendation for folate intake before pregnancy is documented. Furthermore, while current grain fortification has reduced the incidence of NTDs, women who are planning to become pregnant or who could become pregnant should consume at least 400 µg/day of folate from supplements or fortified foods to ensure adequate levels. A healthy diet and prenatal care, which may include additional prenatal vitamins, can help minimize the risk of complications and support the health of both the mother and the fetus.