Folic Acid's Benefits Reduced in Obese Mothers

Tue Feb 1, 5:30 PM ET Health - Reuters


By Will Boggs, MD

NEW YORK (Reuters Health) - Increasing a mother's intake of folic acid by adding the vitamin to food supplies has been shown to cut the risk of having a baby with neural tube defects, a birth defect in which the spine doesn't fuse properly. However, new research indicates that this benefit is much weaker in overweight and obese women.

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"These women may either need higher doses of folic acid or they possess another risk factor related to obesity -- e.g. mild, undetected diabetes mellitus -- that amplifies their risk of neural tube defects, and it is independent of the preventive benefits of folic acid," Dr. Joel G. Ray from University of Toronto, Ontario, Canada told Reuters Health.


As reported in the medical journal Obstetrics & Gynecology, Ray and colleagues examined whether the risk of neural tube defects changed after the introduction of Canada's folic acid fortification program in 1997.


In the heaviest women, the program cut the risk of neural tube defects by 44 percent. In contrast, in lighter women, the program reduced the risk by up to 90 percent.


Prior to fortification, the heaviest women were 40 percent more likely to have a neural tube defect-affected baby than their lean peers, whereas afterward, the increased risk jumped to 280 percent.


"All women should continue to take folic acid tablet supplements before pregnancy, and women who are overweight should consider a small degree of weight reduction before pregnancy," Ray said. "This may lower her risk of having a neural tube defect-affected pregnancy, as well as the forms of high blood pressure and diabetes that are also related to obesity in pregnancy."


"Long-term maintenance of a normal weight, beyond pregnancy, would seem to be one of the most important interventions for maintaining a woman's health over the many years that follow pregnancy," he suggested.


SOURCE: Obstetrics & Gynecology, February 2005.

This is a very negative article. Thanks for nothing.

Most medical things for pregnancy and birth are negative. I am overweight and I have had 5 children all healthy without problems.

I personally think that this is another great way for a doctor to use a scare tactic into getting more u/s done that what is absolutely needed.

I am an OJ drinker while pregnant. Can't get enough of the stuff. I rarely take my folic acid pills too, but I must be ok since I've had 5 healthy babies so far.

Negative or not it's something we need to know.

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Well, there is a different forum for this negative medical advice. I dont' want to read it now. I want to be uplifted. You are infringingin on that with your "help"

You choose what to read. Plus I don't see how this is negative if it informs you. If you are informed then you can do something about it.

I know I will definitely be kicking up the folic acid when I start TTC #6. Being overweight and having 6 babies in 7 years will put me a greater risk of spina bifida for my next baby if I am not getting enough folic acid. I know I worried about it with my last baby and that is why I opted for an u/s. The governement didn't spend millions of dollars on PSA ads about folic acid and pregnancy for nothing. (see http://www.cdc.gov/doc.do/id/0900f3ec8000e5e9 and http://www.cdc.gov/doc.do/id/0900f3ec8000e5f1 )

Which board are you refering me to anyways? Being a member of the overweight and TTC I felt this was a good board to post such an article dealing with overweight women and pregnancy, ESPECIALLY since once you are pregnant then getting enough folic acid to prevent spina bifida won't work. You need enough folic acid prior to getting pregnant in order to prevent spina bifida.

So please explain to me how being informed is negative?

Do you not like being told to lose weight to help decrease medical problems? This is obvious, even I know this and I do know it is hard to lose weight otherwise I wouldn't be over 100 pounds over weight myself! Do you not like being told that you could be putting your baby at risk because of your weight? I know I hate hearing this because not all overweight people are unhealthy. Many are healthy and can carry a baby to term without any problems what so ever (http://www.plus-size-pregnancy.org/firstindex.html) Do you not like reading that the research supports these worries? I don't like it and I also may not agree with it but I now know my risks and can change my habits to help make myself a little healthier at the time I TTC next OR i can choose to ignore the warnings and kep on ding what I am doing and pray fpr the best. That is the great freedom we all have in choosing! Just like you chose to read this article, and just like I chose to post this article!

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While I didn't particularly like hearing what the article said (I hate to think that I might be consciously putting my baby at risk by being overweight), I support Stephanie's decision to post it here. It was an interesting and relevant article. The subject line of the post clearly stated what the article was about so you could choose to ignore it, if you wanted to avoid anything negative.

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Stephanie,

I once posted an informative article and got the same reaction from one person. But personally I think it is best to be well informed than to be ignorant as to what we may or may not be doing to our bodies. I have been at these boards for three years now. But I'm getting closer. If it weren't for these types of articles, I would still be scratching at the same post. And you simply can't trust your doc to know much of anything when all is said and done.

The person who was upset with my post was 1) the only one who thought it was negative, and 2) didn't stop to think that just because it might "hurt" her feelings it could be helping a lot of others. I, therefore, continue to post articles regardless as to whether they are encouraging or discouraging to some. If it helps the greater good, then it should be known.

Please continue to post such great information. If we really want to conquer our infertility we need to face the devils that haunt us.

Thanks for the post.

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LOL I feel the same way I tend to post articles that stir up controversies but this is a VERY tame post compared to some that I've posted in the past. LOL I post about the dangers of hospital births and doctors (I monitor these posts now though) so I was taken aback by the "negative" comment this post got cause this is TAME, ROFLOL but still prepared. This is nothing and I agree it is a preventative article that EVERY woman should read and or know about. Every woman needs folic acid big or small.