Folic acid and Vit D supplementation and pregnancy (Complete)

Question 1

What is the role of folic acid?

Answer 1

Plays an important role in DNA and RNA synthesis

Gets converted into tetrahydrofolate (THF) which helps transfer of 1-carbon units (e.g. methyl, methylene, and formyl groups) to the essential substrates involved in the synthesis of DNA & RNA

Question 2

What are causes of folic acid deficiency?

Answer 2

Pregnancy

Anti-epileptics (e.g. Phenytoin)

Methotrexate

Alcohol excess

Question 3

What are the main complications of folic acid deficiency in pregnancy?

Answer 3

Macrocytic, megaloblastic anaemia

Neural tube defect (e.g. spina bifida)

Question 4

How is prevention of neural tube defects managed in pregnancy?

Answer 4

Normal pregnancy: 400 micrograms of folic acid

• Until 12th week gestation

High-risk pregnancies: 5mg of folic acid

• Pre-pregnancy until 12th week gestation

Question 5

What woman are considered to be high-risk of NTD?

Answer 5

NTD in previous pregnancy

Family history of NTD

Pmx of NTD or pmx in partner

Diabetes

Antiepileptics (e.g. phenytoin, sodium valproate)

Coeliac disease

Thalassaemia trait

Sickle-cell disease

Question 6

Which antiepileptic in particular is associated with increased risk of NTD?

Answer 6

Phenytoin

Question 7

What other supplement is given to all pregnant women?

Answer 7

Vitamin D

Question 8

Why is vitamin D supplementation important in pregnancy?

Answer 8

Helps with foetal bone formation

Question 9

How much vitamin D is given to woman?

Answer 9

400 units (10 micrograms) daily

• From pregnancy and until no longer breastfeeding