A PEER-REVIEWED JOURNAL OF RESEARCH AND CLINICAL MEDICINEISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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An Ideal Folate: Myth or Reality?

DOI:10.31550/1727-2378-2020-19-8-55-60
For citation: Mikhailyukova V.A. An Ideal Folate: Myth or Reality? Doctor.Ru. 2020; 19(8): 55–60. (in Russian). DOI: 10.31550/1727-2378-2020-19-8-55-60

Objective of the Review: To assess the benefits and risks of using various doses and forms of folic acid as part of pre-conception care and during pregnancy.

Key Points: Folic acid (vitamin B9) is known to be an essential microelement, required for DNA replication and several enzyme reactions in amino acid synthesis and metabolism of vitamins. During pregnancy folate requirements rise. According to Order No. 572n of the Russian Federation Ministry of Health, dated November 1, 2012, women should receive folic acid starting in the pre-conception period at doses not exceeding 400 µg/day. A pregnant woman’s folate status is critical for the prevention of folate-associated birth defects and for the baby’s postnatal development. There is still some controversy about the advantages of different forms of folates, the safety of low and high folate doses, the duration of treatment, and the benefits of folates compared with multivitamins.

Conclusion: Currently, there is no doubt that women should receive vitamin-mineral products containing folic acid as part of their pre-conception care and during pregnancy. There is a need, however, for a formal federal protocol for pre-conception care that will guide the use of vitamin-mineral products containing various forms of folates and describe a personalized approach to micronutrient support for various categories of women, including its composition, doses, and duration.

Conflict of interest: The author declares that she does not have any conflict of interests.

V.A. Mikhailyukova — I.I. Mechnikov Northwestern State Medical University (a Federal Government-funded Educational Institution of Higher Education), Russian Ministry of Health; 41 Kirochnaya St. Petersburg, Russian Federation 191015. E-mail: venera.mikhaylyukova@gmail.com

Доктор.ру

Fig. 1. Folate metabolism in the intestine [10]

r9_1.jpg

Fig. 2. Synthesis, breakdown, and metabolism of different forms of tetrahydrofolate (THF) [12]

r9_2.jpg 

Fig. 3. Relationship between the duration of pre-conception care and the effectiveness of folates [16]

r9_3.jpg 

Fig. 4. Time frames for occurrence of folate-associated birth defects2 [4]

r9_4.jpg 

Fig. 5. Placenta-associated complications of gestation [23]

r9_5.jpg 

Received: 21.08.2020

Accepted: 28.09.2020

___________

2 WHO/CDC/ICBDSR. Birth defects surveillance training: facilitator`s guide. Geneva: World Health Organization; 2015. 162 p.


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