Elemental folic acid for periconception

Question 1

When is folic acid the most helpful during pregnancy?

Answer 1

Between 4-10 w of gestation

Neural plate appears at 3w and gives rise to neural folds –> fuse to form neural tube –> tube closes completely by 6w

BUT - most women don’t see a doctor until 3 months
GA

Question 2

What dose of folic acid is recommended to prevent birth defects?

Answer 2

0.4-0.8 mg daily

Higher doses are empirically recommended if hx of pregnancy with NTD (4 mg) or in women who take anticonvulsants

Question 3

What is a serum marker for neural tube defects?

Answer 3

High maternal serum alpha-fetoprotein

Question 4

A 32-year-old woman is preparing for infertility treatment. You counsel her that she can reduce her risk of having a fetus with a neural tube defect (NTD) by taking a supplement that contains the micronutrient:

(A) thiamine
(B) folic acid
(C) pyridoxine
(D) beta carotene

Answer 4

(B) folic acid