Folic acid may help prevent premature births

The rate of premature births continues to increase, but researchers have discovered that a simple way to prevent a woman from having a baby too early may be through the use of folic acid, reports Sade Oguntola.

It is well known that folic acid taken very early in pregnancy can reduce the risk of birth defects of the brain and spinal cord. Now, researchers say the miracle B vitamin can also prevent premature births, a pregnancy problem that afflicts many mothers worldwide.

Prematurity remains one of the most worrisome infant health problems to many nations, both in terms of the babies who die or who are seriously impaired, and in terms of increased health care costs.

The findings are significant because babies born very prematurely are at the greatest risk of complications such as cerebral palsy, mental retardation, chronic lung disease, and blindness.

In a large study that included almost 40,000 women, a team of U.S. and Irish researchers found that women who took folic acid supplements for a year or longer before conception had a 70 per cent rediced risk of preterm birth between 20 and 28 weeks of gestation and up to a 50 per cent reduction in early preterm deliveries of 28 to 32 weeks.

A premature birth is one that occurs before 37 weeks’ gestation. Improved medical knowledge and technology have made survival for these small infants more likely of babies born at 28 weeks or after, 90 per cent are expected to survive.

But the earlier a baby is delivered, the greater the risk of serious complications, including bleeding in the brain, infection, delayed growth and intestinal problems.

The new study included 38,033 women pregnant with one baby. Women who had known pregnancy complications, such as preeclampsia or high blood pressure, and women pregnant with babies with known chromosomal or other birth defects weren’t included in the study.

A baby’s gestational age was determined by ultrasound between 10 and 14 weeks of pregnancy. The women reported folic acid supplementation history to the researchers.

The researchers found that women who took a folic acid supplement for at least a year prior to pregnancy reduced their risk of preterm delivery between 20 and 28 weeks of gestation by 70 per cent. A year of folic acid supplementation dropped the risk of delivering during weeks 28 through 32 by 50 per cent, according to the study.

Dr. Katharine Wenstrom, president of the Society of Maternal-Fetal Medicine and professor of obstetrics and gynecology at Vanderbilt University Medical Centre in Nashville that was involved in the study said: “There have been all sorts of protocols, lifestyle interventions and medications tested, and nothing has made a difference in preterm births, so this is a really exciting study.”

Similarly, another expert, Dr. Alan Fleischman, senior vice president and medical director of the March of Dimes, which promotes folic acid supplementation to prevent birth defects, was of the opinion that this huge decrease in spontaneous preterm delivery for these women who took folic acid for one year prior to conception.

Aside the study providing women considering pregnancy one more reason to begin taking 400 micrograms of folic acid daily, he said: “We hope this new research will spur more health care professionals to urge their female patients to make folic acid part of their daily routine as a simple step towards having a healthy baby in the future.”

Meanwhile, Dr. Sina Adekanmbi, the chief medical consultant, Adeoyo Maternity Hospital, Ibadan, said that given that different things can be responsible for women having premature babies such as the altitude of where she resides, her nutrition, genetic makeup, nutritional intake, abnormalities in her womb and a weakened entrance of the womb, all these factors must be fully accounted for before any person could advocate that folic acid will be beneficial in reducing the incidence of women having premature babies.

“What we know is that folic acid is involved in the building of the DNA and that this basic constituent of the cell is involved in all that has to do with a human being. So, if there is no deficiency in the building of the DNA, they may be reduced cases of premature babies or untimely labour. But that is not to say that what the researcher said about folic acid reducing the incidence of premature babies is not possible. It only requires that they take into account other factors responsible for women having premature babies before out rightly saying that it must be taking hook line and sinker.

“We know that several factors such as stress and infections contributed and that in some of them things like asking them to have bed rest helps to prevent having premature babies, but we only for now give Folic acid and other multivitamins as appropriate to improve their health status, build their blood volume and also protect them from having such babies with complications.

“We also emphasise that they eat lots of leafy vegetables, citrus fruits, beans, and whole grains because they are rich in vitamins, including folic acid,” he said.

Meanwhile, people with a history of premature birth or significant risk factors for premature birth can take the following precautions:
• Seek regular prenatal care. Prenatal visits can help your health care provider monitor your health and your baby’s health.

• Eat healthy foods. During pregnancy, you’ll need more folic acid, calcium, iron, protein and other essential nutrients.

• Manage chronic conditions. Remember, uncontrolled diseases such as diabetes and high blood pressure increase the risk of preterm labour.

• Follow your health care provider’s guidelines for activity. Sometimes it makes sense to scale back on level of physical activities.

• Quit smoking.

• Sex may be off-limits if you have certain complications, such as vaginal bleeding or problems with your cervix or placenta.

• Limit stress. Set reasonable limits — and stick to them.

• Take care of your teeth. Some studies suggest that gum disease may be associated with preterm labour and premature birth.