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Do Low Folic Acid Levels Cause Miscarriage?

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Updated June 14, 2009

Nutrition in Pregnancy

Certain fruits, such as strawberries, can be a good source of folic acid in pregnancy to reduce risk of neural tube defects.

Photo © CDC / James Gathany
Question: Do Low Folic Acid Levels Cause Miscarriage?

Folic acid, or folate, is a nutrient in the B vitamin group. You may have heard about the importance of getting adequate folic acid because it reduces the risk of neural tube defects. But is folic acid important for other reasons also?

Answer:

A lot of research is being done on the impact of folate on various areas of health. It has long been accepted that being deficient in folic acid means a woman will have a higher risk of giving birth to a baby with neural tube defects, birth defects involving the brain and spinal cord. This is why in many countries, including the United States, grain products are fortified with folic acid. Research shows that this fortification has led to a decrease in the incidence of neural tube defects.

Severe neural tube defects, such as anencephaly, may be incompatible with life and thus can result in late pregnancy loss.

A few studies have also suggested that being deficient in folic acid is associated with higher risk of early miscarriage. One 2002 study by Swedish researchers found that women with low folate levels had a significantly increased risk of having a miscarriage affected by chromosomal abnormalities. The study also found that having high folic acid did not increase risk of miscarriage.

In addition, a 2008 study found that men who were deficient in folate had higher rates of chromosomal abnormalities in their sperm.

The research is not yet strong enough for doctors to advise that taking extra folic acid can actually prevent miscarriages, but if you're worried, it probably can't hurt to try. Doctors do advise taking extra folic acid supplements to prevent neural tube defects, so possible reduced risk of miscarriage might ultimately be shown to be a side benefit of this policy.

Beside helping with pregnancy outcomes, adequate folic acid levels might also have heart benefits, although these need to be confirmed by further research. Doctors advise getting at least 400 micrograms of folic acid each day. Beside prenatal vitamin supplements, which usually contain the recommended minimum amount of folic acid, good food sources of folic acid include fortified breakfast cereals, leafy green vegetables, nuts and legumes, liver, and other healthy foods.

Sources:

Centers for Disease Control, "Folic Acid: Frequently Asked Questions." Pregnancy Information 30 Jan 2008.

George, Lena, James L Mills, Anna L. V. Johansson, Anna Nordmark, Bodil Olander, Fredrik Granath, and Sven Cnattingius, "Plasma Folate Levels and Risk of Spontaneous Abortion." JAMA 2002. Accessed 22 Mar 2008.

Young, S.S., B. Eskenazi, F.M. Marchetti, G. Block, and A.J. Wyrobek, "The association of folate, zinc and antioxidant intake with sperm aneuploidy in healthy non-smoking men." Human Reproduction Mar 2008. Accessed 22 Mar 2008.

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  3. Miscarriage / Pregnancy Loss
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  5. Folic Acid and Miscarriage - Does Folate Deficiency Increase Risk of Miscarriage

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