Effects Of Maternal Folic Acid Supplementation On The Development Of Neural Tube And Cardiovascular System Of The Off Springs In Human And Animal Models

Folate is a water-soluble vitamin B present in legumes (e.g. beans, peas and lentils), leafyrngreen vegetables (e.g. spinach and asparagus), liver and certain fruits (e.g. banana,rncantaloupe and strawberry). Folic acid supplementation to pregnant women had no acuternand long-term adverse effects on the health status of mothers as well as the new born infants.rnMaternal folic acid supplementation had no significant association with multiple births.rnMaternal folic acid supplementation had a protective effect for neural tube defects (NTDs)rnespecially spina bifida and anencephaly. Concomitant administration of maternal folic acidrnand methionine may also prevent retinoic acid induced cleft palate than use of folic acidrnalone. Maternal obesity before pregnancy with body mass index (BMI) ≥30 kg/m2 wasrnsignificantly associated with an approximately two fold increased risk of NTDs in offspring.rnThe NTD protective association of folic acid was also stronger in overweight/ obese womenrnBMI ≥ 25 kg/m2 than in normal/underweight women BMI < 25 kg/m2. Food fortification withrnfolic or maternal supplementation of folic acid may have a protective effect for coarctation ofrnaorta and left ventricular outflow tract obstruction, but no significant association wasrnobserved for tetralogy of Fallot and d-transposition of the great arteries.rnHigh doses of daily maternal folate supplementation (50 mg/kg/day) during embryonic/fetalrndevelopment are necessary for early post-implantation embryonic viability, chorioallantoicrnfusion, hematopoiesis, and the development of neural tube and heart. Maternalrnsupplementation of multivitamin containing folic acid had more effective in preventing NTDsrnand congenital heart defects (CHDs) than use of folic acid alone, if it starts two monthsrnbefore conception and continues until completion of the second month of pregnancy and thernfrequency should be higher than five times per week. Use of vegetable and fruit duringrnpregnancy also has a beneficial effect in preventing NTDs.rnDespite the protective effect of folic acid in NTDs by facilitating the neural tube closure,rnadditional investigation is required to understand the exact mechanism of action of folic acidrnin neural tube.rnKey words: folic acid; maternal; supplementation; NTDs; CHDs

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