Folic Acid Supplementation for Pre-Pregnancy

Introduction to Folic Acid

The American College of Medical Genetics recommends that all women planning pregnancy take a daily folic acid supplement of 400 μg (0.4 mg) starting at least 1-3 months before conception and continuing through the first trimester to reduce the risk of neural tube defects 1, 2, 3
Daily folic acid supplementation of 400 μg (0.4 mg) is recommended for all women of childbearing age who could become pregnant, according to the American College of Medical Genetics 4, 5

Folic acid supplementation should begin at least 1-3 months before conception and continue through the first 12 weeks of pregnancy, as recommended by the American College of Medical Genetics 2, 3
Folic acid significantly reduces the risk of neural tube defects (NTDs) by 40-80%, according to the American College of Medical Genetics 3

Women with higher risk factors, such as personal history of a previous NTD-affected pregnancy, should take 4 mg (4000 μg) of folic acid daily starting at least 3 months before conception through the first 12 weeks of pregnancy, as recommended by the American College of Medical Genetics 2, 3
High-risk factors for neural tube defects include personal history of a previous NTD-affected pregnancy, first-degree relative with an NTD, being personally affected by an NTD, and partner with personal history of NTD, according to the American College of Medical Genetics 2, 4

Total daily folic acid intake should not exceed 1 mg (1000 μg) unless prescribed by a physician, as recommended by the American College of Medical Genetics 4, 3
Higher doses of folic acid may potentially mask vitamin B12 deficiency, which could lead to irreversible neurological damage if left untreated, according to the Centers for Disease Control and Prevention 6

Since more than 50% of pregnancies are unplanned, continuous folic acid supplementation is recommended for all women of childbearing age, as recommended by the Centers for Disease Control and Prevention 6, 7
Excessive zinc supplementation may interfere with copper absorption, according to the World Health Organization 8
Women with type 2 diabetes or BMI >30 kg/m² should take 5 mg folic acid daily until the 12th week of pregnancy, as recommended by the National Institute of Health 8, 9