Last week I wrote about folic acid and how it may be associated with a reduced risk of premature birth. A recently published study (1) has found that folic acid may also reduce the risk of a baby being born with severe congenital heart defects (heart defects present from birth).
The study took place in Quebec, Canada(1). The researchers wanted to see whether the fortification of food programme, that has been in place since 1998 and has already proved to be effective in preventing neural tube defects, had impacted the incidence of severe congenital heart defects. The 1998 government policy requires the mandatory fortification of flour in Canada with folate.
The study(1) looked at infants who were born between 1990 – 2005 who had severe congenital heart defects. The scientists then analysed the data to compare rates of heart defects before and after the food policy was in place. Among the 1 324 440 births in Quebec between 1990-2005 there were 2083 infants born with severe congenital heart defects. Analysis of the results showed no change in the birth prevalence of severe birth defects in the nine years before fortification, while in the seven years after fortification there was a significant 6% decrease per year. The authors of the study conclude that the public health measures to increase folic acid intake in Canada were followed by a decrease in the birth prevalence of severe congenital heart defects. The findings support the hypothesis that folic acid has a preventive effect on heart defects.
According to Raluca Ionescu-Ittu, a PhD candidate on the team, “this decrease is very significant and probably underestimated. During the study period, there was an increase in other factors associated with a higher prevalence of congenital heart defects, so without the fortification we would probably have seen an increase in these defects.” (2)
Despite the positive findings the authors of the study stress the need for women of childbearing age, especially those planning a pregnancy, to take folic acid supplements and not rely on food as a source. The fortification programme was aimed at the general population, women planning a pregnancy need extra folic acid, it is a good idea for pregnant women to take a folate supplement at least three months before becoming pregnant. Data that I mentioned last week indicates that there are benefits to taking a folate supplement a year prior to conception. Folic acid seems to have effects on various aspects of embryonic and infant development. Natural sources of the vitamin, such as green vegetables, might not provide sufficient doses for pregnant women. Most medical doctors therefore recommend supplements in addition to a healthy diet rich in folic acid.
As I have previously stressed: it is important for any woman who is planning a pregnancy to aim to eat a consistently healthy diet rich in vegetables, fruits, healthy fats and unprocessed meats, fish and wholegrain unrefined carbohydrates. A healthy diet really does affect the unborn child, probably in more ways than we currently know through scientific investigation. It may also be worth to consider taking a broad spectrum multivitamin and mineral food-state supplement specifically designed for pregnancy in order to maintain good levels of all essential nutrients. An omega 3 fatty acid supplement could also be considered, especially if oily fish and nuts/seeds are not regularly eaten. Before deciding to take any supplement during pregnancy please discuss your thoughts with a GP, nurse or midwife.
(1)Ionescu-Ittu R et al. 2009. Prevalence of severe congenital heart disease after folic acid fortification of grain products: time trend analysis in Quebec, Canada. BMJ 2009;338:b1673
(2) McGill University Health Centre (2009, May 14). Folic Acid Effecive In Preventing Congenital Heart Defects, Canadian Research Shows. ScienceDaily. Retrieved May 19, 2009, from http://www.sciencedaily.com¬ /releases/2009/05/090514111404.htm
Written by Ani Kowal
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- Taking folic acid before pregnancy is associated with a reduction in premature birth
- Can vitamin B12 help to prevent birth defects?
- Folate may be related to cancer prevention in women
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