Back pains, edema and pelvic girdle pain withstanding, pregnancy is a beautiful thing. A healthy pregnancy that yields a healthy child is far more beautiful. However, a healthy pregnancy hinges on choices, including the choice to intake folate/folic acid on a daily basis prior to pregnancy.

According to the March of Dimes, Hispanic women of childbearing age have the highest birth rate of all racial/ethnic groups. A recommendation for women of childbearing age is that they ingest the B vitamin folate or 400 micrograms of folic acid, a synthetic form of folate that is found in enriched grain products and dietary supplements, to ensure that future children aren't born with certain birth defects. This is important information to press onto the Hispanic community because Hispanic women are less likely than their non-Hispanic counterpart to report taking a multivitamin prior to becoming pregnant.

"The benefits of folic acid and the risks of not having enough folic acid have to do with birth defects, specifically a class of birth defects called neural tube defects. That's when the neural tube, which encloses the spine, closes. That actually happens right around the time when a woman misses her period, and just becomes aware that she's pregnant," Dr. Siobhan Dolan, an OB/GYN and medical advisor to the March of Dimes, told Latin Post. "Basically, what the data has shown is that if a woman has enough folate, there's a lower risk of having a neural tube defect. If a woman is deficient in folate, then she has an increased risk of having a neural tube defect."

Neural tube defects (NTDs) include spina bifida and anencephaly, which are birth defects of the brain and spine that result in life-long disability and mortality. The trick to ensuring that NTDs are less likely to develop is to take a folic acid supplement not only during the very early stages of pregnancy, but one month prior to becoming pregnant. Waiting until after pregnancy to take folic acid means that a soon-to-be mother could miss the opportunity to decrease the risk of NTDs.

Even with 30-40 percent declines in NTD rates across all three major race/ethnicity groups since folic acid fortification was introduced in the U.S. during 1998, NTDs are still significantly higher among births to Hispanic women compared to non-Hispanic women. In 2010, the leading cause of infant mortality among Hispanics was birth defects, and infant deaths among Hispanics accounted for 20 percent of all infant deaths in the U.S.

"National guidelines advised that all women capable of becoming pregnant, of reproductive age, or women who might become pregnant should take a folic acid supplement of 0.4 mg (400 micrograms) daily in addition to a healthy well-balanced diet," said Dr. Dolan. "What we know is that there are many food sources that offer folic acid/folate, such as leafy green vegetables, including broccoli, spinach, asparagus and peas. Also, lentils, grapefruit, oranges juice and fortified cereals. However, guidelines advise taking a folic acid supplement because the benefits are so tremendous and outweigh any risk.

"A lot of women don't have intake adequate folate through their diets. The importance of folic acid is so great that U.S. fortified cereals and wheats so that there's additional folic acid to reach women."

The recommendation of 400 micrograms of folic acid is normally contained in a multivitamin or prenatal vitamin, which, again, women should begin taking a month before they become pregnant. However, because half of pregnancies in the U.S. are unplanned, the children of those women are far more vulnerable to NTDs than women who consume folic acid.

"The message is all women who can become pregnant should take a multivitamin or a prenatal vitamin containing folic acid. We want to get that message to everyone, not just women who are planning a pregnancy, we really want to change the message to pre-conception ... before you become pregnant," said Dr. Dolan. "No, not change the message, but emphasize that you don't implement changes in your lifestyle after becoming pregnant, do that before. Everyone wants a healthy pregnancy, and women are so motivated by the prospect of having a child that they're willing to change their lifestyle."

Dr. Dolan communicated that she and the March of Dimes applaud and support women who make changes in their lives for their children. Those changes include, but are not limited to giving up alcohol, getting to a healthy weight, taking folic acid, visiting a doctor and making sure medications are safe for pregnancy. She wants to emphasize that the best case scenario involves taking folic acid before getting pregnant. Also, figuring out what the safest anti-depressants are, if taking them, and figuring out when to quit smoking.

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