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Folates in pregnancy and lactation

Folates play a decisive role in the embryonic development. Maternal folate and micronutrient requirements increase during pregnancy due to fetal demands for growth and development. Moreover, an increased cell division is associated with the rapidly growing placenta. Due to the higher demands of folate, pregnant women are at higher risk of developing folate deficiencies and megaloblastic anemia (1). Inadequate folate intake (below the RDA of 550 µg/day for pregnant women) and low serum folate concentrations (especially < 7 nmol/L), are associated with poor pregnancy outcomes.


Sufficient folates intake is important during lactation. Maternal dietary requirements of folates are likewise high as during pregnancy. Human milk folate varies from 20 – 40% of 5-methylTHF in polyglutamate form and is bound to FBPs. Milk folate concentrations are typically 5 – 10fold higher than that of the maternal plasma. Due to high folate loss during the lactation, the maternal folate status can deteriorate, especially when FA is not supplemented.

References

1.     Willoughby ML. An investigation of folic acid requirements in pregnancy. Br J Haematol 1967;13:503-9.