| Folate’s Role in Maternal and Fetal Health: Evolving Science
Pregnancy is associated with a marked acceleration in folate-dependent one-carbon transfer reactions, including those required for DNA synthesis and cell division. Research confirms that folate plays a significant role in ensuring normal maternal health and fetal development and that genetics influences folate metabolism. Research findings have been translated into new folate intake recommendations for pregnant women and women of reproductive age. Based on data obtained primarily from controlled metabolic studies, the Institute of Medicine dramatically increased the folate recommended dietary allowance for pregnant and nonpregnant women. Folic acid-neural tube defect (NTD) studies have conclusively established that folic acid taken periconceptionally significantly reduces the risk of NTDs. Public health policies have been implemented including folic acid fortification and guidelines for folic acid consumption for women capable of becoming pregnant. The mechanism by which folic acid reduces NTD risk is unknown; however, it is hypothesized that supplemental folic acid may overcome a metabolic defect that impairs folate utilization. The influence of genetics, specifically mutations affecting folate enzymes, is the focus of research investigations. A common genetic mutation affects the gene encoding methylenetetrahydrofolate reductase resulting in reduced blood folate and elevated homocysteine concentrations. Evolving data from metabolic studies will lead to conclusions related to the potential for increased folate intake to modulate the negative impact of folate-related mutations in women of reproductive age. |