Folate and Pregnancy, current concepts. It is required folic acid supplementation ?

Abstract

Folate intake during pregnancy is essential for an adequate fetal and placental development, as well as for the long-term health condition. Because folate deficiency may induce fetal pathologies, including neural tube disease (NTD), several countries have set up public policies to fortify foods with folic acid (FA). Chile started the fortification of wheat flour with FA in the year 2000, decreasing in 43% the prevalence of NTD. However, despite the high consumption of bread (the main fortified food with FA) by our population, a high number of pregnant women consume FA supplements, exceeding the maximal recommended FA intake. Additionally, if the diet is reduced in vitamin B12, the optimal ratio folates/vit B12 may be altered, inducing changes in the methylation of specific genes and other metabolic pathways, affecting fetal development and the long-term health of the neonates. We think that, after 16 years of the initiation of the fortification of wheat flour with FA, it is necessary to evaluate the possible side effects of an excess of FS intake in the pregnant population and their offspring. This article shows current concepts about mechanisms of folates and vit B12 at cellular level, and their possible consequences of an elevated FA maternal intake on the offspring.