Low Folate Levels and Miscarriage Risk

 

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Do low folic acid levels cause miscarriage? A few studies have suggested that being deficient in folic acid is associated with a 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.   Not all studies, however, show.

Folate deficiency also has been associated with placental separation during pregnancy, pregnancy-induced hypertension, and low blood supply to the placenta. These effects may in part be responsible. Pregnant women who have low blood levels of the vitamin folate are more likely to have early miscarriages than are pregnant women who have adequate folate levels, according to a study of Swedish women by researchers at the Karolinska Institute in Sweden and at the National Institute of Child Health and Human Development (NICHD). Two recent cohort studies reported that the use of folic acid or multiple vitamins during pregnancy was associated with a 50–60% reduced risk of miscarriage (28, 29).Our study allowed us to improve on previous studies by contrasting the relationship between prepregnancy folate from food and supplements and spontaneous abortion and to examine a dose-response relationship.

After all the risk factors had been taken into account, women with low folate concentrations had a higher risk of miscarriage, compared with women whose plasma folate concentration was between 5.0 and 8.9 nmol/l (odds ratio 1.47 (95% confidence interval 1.01. Low folate status associated with 47% higher risk of miscarriage, may cause abnormal karyotype. Compared with women with plasma folate levels between 2.20 and 3.95 ng/mL, women with low (< or =2.19. MTHFR handles the breakdown of the vitamin folic acid. This breakdown leads to elevated levels of homocysteine.

Homocysteine is a chemical produced from an amino acid in our bodies when folic acid. Folate levels in your body can become low in just a few weeks if you don’t eat enough folate-rich foods. Disease. Diseases that affect absorption in the gastrointestinal tract can cause folate. The biggest sign of folate deficiency is megaloblastic anemia, a condition in which the body has a low number of abnormally large red blood cells, according to the National Institutes of Health.

Low blood folate levels are associated with an increased risk of cervical, breast, colon, brain and lung cancer. Epidemiologic evidence generally indicates that a high intake of folate-rich foods offers protection against the development of some common cancers, but the relationship between folic acid and cancer is complicated, as you’ve learned.

List of related literature:

This was seen when a group of women with unexplained recurrent miscarriage were given 600 mg per day along with folic acid, and the pregnancy outcomes compared to women taking folic acid alone.

“It Starts with the Egg: How the Science of Egg Quality Can Help You Get Pregnant Naturally, Prevent Miscarriage, and Improve Your Odds in IVF (Second Edition)” by Rebecca Fett
from It Starts with the Egg: How the Science of Egg Quality Can Help You Get Pregnant Naturally, Prevent Miscarriage, and Improve Your Odds in IVF (Second Edition)
by Rebecca Fett
Franklin Fox Publishing LLC, 2019

Homocysteine and folate levels as risk factors for recurrent early pregnancy loss.

“Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment” by Christof Schaefer, Paul W.J. Peters, Richard K Miller
from Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment
by Christof Schaefer, Paul W.J. Peters, Richard K Miller
Elsevier Science, 2014

Maternal hyperhomocysteinaemia and poor folate status are risk factors for recurrent embryo loss and for first early embryo loss (George et al 2002).

“Herbs and Natural Supplements Inkling: An Evidence-Based Guide” by Lesley Braun, Marc Cohen
from Herbs and Natural Supplements Inkling: An Evidence-Based Guide
by Lesley Braun, Marc Cohen
Elsevier Health Sciences APAC, 2010

Those women who have already had one conception affected by a NTD are advised to consume 4 mg folic acid per day to reduce the risk of recurrence.

“Anatomy and Physiology for Midwives E-Book” by Jane Coad, Kevin Pedley, Melvyn Dunstall
from Anatomy and Physiology for Midwives E-Book
by Jane Coad, Kevin Pedley, Melvyn Dunstall
Elsevier Health Sciences, 2019

This finding is the basis for the Center for Disease Control and Prevention’s (CDC) recommendation that women of childbearing age who have a chance of becoming pregnant consume 0.4 mg of folate per day from 1 month preconception until the end of the first trimester.

“The Active Female: Health Issues Throughout the Lifespan” by Jacalyn J. RobertMcComb, Reid L. Norman, Mimi Zumwalt
from The Active Female: Health Issues Throughout the Lifespan
by Jacalyn J. RobertMcComb, Reid L. Norman, Mimi Zumwalt
Springer New York, 2014

Because treatment with folate and pyridoxine normalized the homocysteine level and favored a subsequent successful pregnancy, it may be that some recurrent miscarriages are associated with hyperhomocysteinemia.510 Maternal folate deficiency is also related to fetal hypotrophy.

“Nathan and Oski's Hematology of Infancy and Childhood E-Book” by Stuart H. Orkin, David G. Nathan, David Ginsburg, A. Thomas Look, David E. Fisher, Samuel Lux
from Nathan and Oski’s Hematology of Infancy and Childhood E-Book
by Stuart H. Orkin, David G. Nathan, et. al.
Elsevier Health Sciences, 2008

Low folate levels are associated with miscarriages, LBW, and preterm birth.

“Krause and Mahan’s Food and the Nutrition Care Process E-Book” by Janice L Raymond, Kelly Morrow
from Krause and Mahan’s Food and the Nutrition Care Process E-Book
by Janice L Raymond, Kelly Morrow
Elsevier Health Sciences, 2020

The continued supplementation of 400 mcg folic acid daily in the second and third trimester of pregnancy has been found to increase maternal and placental cord blood folate status, and prevent the increase in homocysteine concentration that otherwise occurs in late pregnancy (McNulty et al 2013).

“Essential Herbs and Natural Supplements” by Lesley Braun, Marc Cohen
from Essential Herbs and Natural Supplements
by Lesley Braun, Marc Cohen
Elsevier Health Sciences, 2017

Thus, to ensure good maternal and fetal health, all pregnant women should receive sufficient dietary or supplementary folic acid to maintain normal maternal folate levels.

“Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk” by Gerald G. Briggs, Roger K. Freeman, Sumner J. Yaffe
from Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk
by Gerald G. Briggs, Roger K. Freeman, Sumner J. Yaffe
Lippincott Williams & Wilkins, 2008

The risk of NTD was found to be 10-fold higher (6 affected pregnancies per 1000) in people with poor folate status (i.e., less than 150mg red cell folate per litre) than in those with good folate status (400 mglÀ1).

“Encyclopedia of Human Nutrition” by Benjamin Caballero, Lindsay Allen, Andrew Prentice
from Encyclopedia of Human Nutrition
by Benjamin Caballero, Lindsay Allen, Andrew Prentice
Elsevier Science, 2005

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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2 comments

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  • thanks for the clear video and info! I just got informed i’m folic deficient, been losing weight for months no idea why, I consume plenty fruit and veg, and am a 33yr old male so not pregnant lol. Also diagnosed with ADHD last year and I am wondering how long and how much of an impact this hidden deficiency has been having on me. Doctors prescribed me with folic acid tablets, but I am fairly sure they’re ignoring the fact that I tell them I eat plenty of B vit foods and even take a regular B vit complex too…

  • Thank you for such a good explanation!
    But, a small doubt. Can jaundice be caused because of folate deficiency as there can be ineffective erythropoiesis and destruction of erythroid progenitors?