Pregnant women with low blood levels of the B vitamin folate (folic acid) may be at higher risk for miscarriage than women with more of the vitamin in their blood, Swedish researchers report. The results argue in favor of adding folic acid--the form of the vitamin found in supplements--to food. While folate, which occurs naturally in leafy green vegetables, lentils, orange juice and other foods, and folic acid are known to lower the risk of neural tube defects, its role in miscarriage is uncertain. Some studies have found that folate deficiency raises the risk but other reports have suggested that elevated blood folate is a risk factor for miscarriage.
To investigate, the researchers measured blood levels of the vitamin in 468 women who had a miscarriage and more than 900 women who delivered healthy babies. Blood was drawn between 6 and 12 weeks of gestation. Women with low blood folate levels were nearly 50% more likely to have a miscarriage than women whose blood levels were higher. Higher blood folate levels were not associated with miscarriage.
It is not clear how low blood folate contributes to miscarriage. It is possible that a fetus with a neural tube defect is more likely to be miscarried. Alternatively, other pregnancy-complicating conditions, which are also associated with low maternal blood folate levels, may play a role.
Women are advised to take a daily supplement containing 400 micrograms (mcg) of folic acid before they conceive and during the early months of pregnancy. During pregnancy, folate requirements increase to 600 micrograms daily.
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