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EFFECT OF FOLIC ACID USE DURING PREGNANCY ON NEURAL TUBE
DEFECTS
Ortikova Munisa Yusufaliyevna
Republic Specialized
Scientific and Practical Medical Center for Maternal and Child Health
Abstract:
Neural tube defects (NTDs) are a group of severe birth defects in the development of
the central nervous system of the fetus. Studies have shown that adequate folic acid intake before
and during the first weeks of pregnancy significantly reduces the risk of these defects. This
article reviews the biological role of folic acid, the pathogenesis of NTDs, possible risk factors,
and the results of preventive folic acid administration.
Keywords
: folic acid, neural tube defect, pregnancy, prevention, spina bifida, anencephaly
Neural tube defects (NTDs) are congenital abnormalities that occur when the central nervous
system fails to close completely during the embryonic period, including spina bifida,
anencephaly, and encephalocele. NTDs develop during the 3rd to 4th week of pregnancy, when
most women are unaware they are pregnant.
More than 300,000 babies are born with NNC each year worldwide. Studies show that taking
folic acid before and during pregnancy can prevent up to 50–70% of these cases.
The purpose of the article is to analyze the importance of folic acid in preventing neural tube
defects based on scientific sources and to evaluate approaches in this regard in Uzbekistan.
Information sources:
Recommendations published by WHO, CDC, PubMed, UpToDate, and the Uzbek
National Institute of Health (2010–2024);
More than 20 clinical studies and meta-analyses related to NNN.
Criteria evaluated:
The effect of folic acid on fetal development;
The rate of development and reduction of NNN;
Prophylactic doses and duration of their use.
Effects of folic acid:
Factor
Result
400–800 mcg of folic acid daily
Reduces the risk of IDU by 50–70%
Along with additional vitamin B12
The effect will increase further.
Starting 1 month before pregnancy
The most effective protection is provided
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Research results:
MRC Vitamin Study (1991)
: In a group of women who took folic acid before pregnancy,
the incidence of spina bifida was reduced by 72%.
WHO recommendation
: Every woman planning a pregnancy should take at least 400
mcg of folic acid per day.
Uzbekistan surveillance (2021)
: Only 38% of women consumed folic acid before
pregnancy.
Folic acid (vitamin B9) plays an important role in DNA synthesis and cell division. In the early
weeks of embryonic development — especially during the neural tube closure process — a
deficiency of this vitamin can cause severe defects.
The main risk factors for the development of NNN are:
Folic acid deficiency;
Mother taking diabetes or anti-epileptic medications;
Racial factors (if NNN was observed in the first child);
Socioeconomic disadvantage.
Also, while it's important to get folic acid through a healthy diet, it's not enough—supplements in
pill form are more biologically beneficial.
In developed countries, folic acid is now mandatory added to bread and flour products
(fortification). This approach has significantly reduced the incidence of IBD.
In Uzbekistan, this requires public awareness, planned pregnancies, and widespread
implementation of preventive recommendations by doctors.
Folic acid is one of the most important preventive measures during pregnancy. Taking it before
and in the first weeks of pregnancy prevents neural tube defects.
Recommendations:
Every woman of childbearing age (if planning) should be recommended a minimum of
400 mcg/day of folic acid;
In women with recurrent NNN — increasing the dose to 4 mg/day is considered;
The healthcare system should introduce the practice of free provision of pregnancy
planning and nutritional supplements;
Widespread information campaigns about safe pregnancy should be conducted among the
population.
References
1.
MRC Vitamin Study Research Group. (1991). Prevention of neural tube defects: Results
of the Medical Research Council Vitamin Study. Lancet, 338(8760), 131–137.
2.
World Health Organization. (2016). Guideline: Optimal serum and red blood cell folate
concentrations in women of reproductive age for prevention of neural tube defects.
3.
Centers for Disease Control and Prevention (CDC). (2020). Folic Acid Helps Prevent
Neural Tube Defects.
4.
Crider, KS, Bailey, LB, & Berry, RJ (2011). Folic acid: its role in pregnancy and
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implications for health. Journal of Advanced Nutrition, 1(1), 13–22.
5.
Artiqova, MY (2022). The effect of folic acid on neurological development: a clinical
analysis. Medicine and Innovations, (2), 33–37.
