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How to have a healthy and smart baby? Folic acid and vitamins to help
Published: 2016-07-12 Author: Blue Spirit Parenting Network editor Parenting Network h20pulse.com
Having a healthy and smart child is the greatest wish of every couple and every family. With the improvement of people's living conditions and the improvement of the overall medical level, the quality and quality of the entire population has also continuously improved. However, at the first juncture of human reproduction, the birth defects of newborns during perinatal period are still an important issue that cannot be avoided or underestimated!
At present, a large number of medical studies have confirmed that the combined supplement of folic acid and multivitamins during perinatal period is of great benefit to the pregnancy process, fetal development and postpartum health.
1. What is a newborn birth defect?
When the baby is born, there are abnormalities in form, structure and function. According to incomplete statistics, currently among all newborn birth defects in China, the fourth place is neural tube defects, accounting for about 1/13.
Generally speaking, the incidence of newborn birth defects in China is 4% -6%, which is higher than 2% -3% in developed countries. Moreover, China has a large population base and a large number of patients, which has caused serious economic burden and Social burden, the national expenditure on diagnosis and treatment of this type of disease exceeds 20 billion yuan each year.
The main causes of birth defects include:
① Genetic defects: mainly various types of genetic mutations and chromosomal abnormalities;
② Smoking, drinking and other bad living habits and exposure to toxic and harmful substances;
③ Lack of nutrition, illness, and infection with pathogens;
④ Taking chemical drugs (including some traditional Chinese medicines) for a long time;
⑤ Lack of trace elements such as folic acid.
2. How to prevent birth defects during pregnancy?
Some of the more effective prevention measures include:
① consumption of iodized salt-to prevent endemic cretinism;
② Vaccination against rubella-prevention of 1/1000 congenital rubella syndrome;
③ Avoid close relatives and older births-prevent single gene and chromosomal abnormalities;
④ Early detection and treatment of diseases such as diabetes and hypertension, avoiding exposure to harmful substances (heavy metals, solvents, pesticides, etc.) during pregnancy, avoiding random medication during pregnancy and pregnancy, avoiding unnecessary drug use and heavy drinking during pregnancy, refusing to smoke and second-hand smoke Can reduce the risk of multiple birth defects;
⑤ Supplement folic acid and vitamins-prevent 90% of neural tube defects, 15% of other major surface deformities, 35% of congenital heart disease;
Of course, doing these can only prevent some birth defects, and for genetic diseases, you can only rely on prenatal screening, inspection and even prenatal diagnostic techniques (amniotic fluid puncture, cord blood puncture, chorionic biopsy, etc.) to further check.
3. Why should we supplement folic acid during pregnancy?
Perinatal folic acid supplementation is a successful case in the development of modern evidence-based medicine.
In the early days, humans did not know that pregnant women needed additional folic acid supplements. It was discovered in the medical profession to detect and treat neonatal malformations, neural tube defects.
Folic acid is a member of the vitamin B complex family. It was named after being extracted and purified from spinach leaves in 1941; folic acid is an essential substance in the human body. It is used in cell growth and division, protein and nucleic acid synthesis, and blood cells. And hemoglobin metabolism play an important role.
Current research has proven that maternal folic acid deficiency can cause hyperhomocysteinemia, lead to cellular DNA damage and apoptosis during fetal development, and eventually cause neural tube defects. This mechanism accounts for 90% of all diseases the above!
Of course, other environmental factors (such as lack of vitamin B and excessive methionine) and some genetic factors (such as some genetic abnormalities, abnormal enzymes or transcription factors) can also cause neural tube defects, but the incidence is low. Moreover, more than 95% of neural tube defects occur during the first successful pregnancy.
The types of neural tube defects currently found include: anencephaly, cranial spina bifida, open spina bifida, occipital fissure deformity, meningocele, and closed spina bifida. For the defects caused by genetic factors, the current prevention and treatment methods are limited. It is expected that assisted reproduction technology can be further developed. In the future, fertilized egg transplants without such genetic diseases can be selected. For defects caused by environmental factors, proactive prevention and initiative can be adopted. Supplements are effectively avoided.
Surveys show that folic acid deficiency is common in women of childbearing age in China. After pregnancy, fetal growth increases the need for folic acid, and the overall bioavailability of folic acid in the diet is generally low, so oral folic acid supplementation is necessary.
Many studies have shown that the risk of NTD decreases by nearly 41% after daily intake of 200g of folic acid; meanwhile, taking folic acid can also reduce the incidence of cleft lip and palate and premature birth. A small amount of folic acid supplementation can benefit patients with pernicious anemia, and folic acid can also cause Cancer cell apoptosis, can resist leukemia. Folic acid supplementation during pregnancy and postpartum helps infants with brain cell growth and mental improvement; the probability of chromosomal abnormalities in sperm after men's intake of folic acid is much lower than ordinary people!
Therefore, both pregnant and pregnant women should be supplemented with folic acid.
4. When is the most effective time to start folic acid supplementation?
Because fetal neural tube generation and closure is completed within 28 days after fertilization, it may be too late when pregnancy is found to start replenishment. There is a large amount of evidence that folic acid is taken orally every day at least 1 month before pregnancy. The author also recommends that for the sake of insurance, you should start taking folic acid 3 months before pregnancy to ensure sufficient folic acid intake and blood concentration to minimize the risk of neural tube malformation.
In fact, the nutrients (vitamins, minerals) required by pregnant women, the elderly, and children are generally not adequately supplied from food, so they need to be fortified and added. European and American women add folic acid (approximately 100g / 100g flour) to flour and bread and take 400g folic acid tablets orally; in China, because there is no fortification in food, experts agree that the daily intake of pregnant women is 800g (200g-400g before pregnancy), mainly Is achieved through oral medication.
It is generally believed that the maximum intake of normal adults is 1000 g / d, which will not be poisoned when it exceeds the minimum adult demand by 20 times, and excess folic acid can be excreted from the urine. However, the material must be reversed. Taking large doses of folic acid may also have certain toxic effects, such as inducing seizures in patients; affecting zinc absorption, causing fetal growth retardation, and causing damage to the fetal nervous system. For pregnant women, 400-800g / d is safe.
5. Perinatal folic acid and vitamin supplementation is even better!
Previous studies have shown that folic acid and vitamins B2, B6, and B12 all participate in homocysteine metabolism, which has a synergistic effect and can better prevent neural tube defects. In addition, different vitamins and trace elements promote each other, such as : Vitamin C can prevent vitamin E from being oxidized; selenium and vitamin E have a synergistic effect, which can enhance the effectiveness of each other; vitamins can increase the absorption of iron; vitamin E can reverse the decrease of free magnesium concentration in cells; and supplement iron and vitamin A has a good effect on improving anemia in pregnant women, and is better than supplementing with iron or vitamin A alone.
In addition, other vitamins, minerals, and trace elements can also help optimize pregnancy outcomes. It can be seen that the combined supplement of folic acid and multivitamins can make mothers and children benefit more!
We emphasize that starting folic acid and multivitamin supplementation from 1 to 3 months before pregnancy, not only because of reducing birth defects, but also more benefits: the menstrual cycle is more regular than before, the conception rate can be increased by 5%, and the time to successful pregnancy will also be shorten. Supplementing multiple vitamins and minerals during pregnancy can reduce vomiting and early pregnancy, does not increase the weight of pregnant women, and can significantly reduce diseases other than NTD, including: maxillofacial fissure, cardiovascular malformations, urinary tract malformations, lack of limbs, Hypertrophic pyloric stenosis, rectal / anal atresia / stenosis.
In the lactation period, pregnant women still need to supplement, because folic acid and multivitamins can effectively fill a large number of nutrients lost during pregnancy and breastfeeding, and help postpartum recovery of breastfeeding mothers. It can improve the nutritional status of mothers and enhance the quality and quantity of breast milk. Helps baby develop healthily. We therefore recommend that the end of supplementation can be postponed until the end of breastfeeding!
6. What should I do if I haven't started getting folic acid supplementation?
In daily life, many pregnant women will face a problem: they do not start to supplement folic acid when preparing for pregnancy, and do not check it until the holiday does not come on time, and found that they are pregnant. What should I do at this time?
The latest research shows that at any stage before the end of a woman's first pregnancy, supplementation with folic acid, even in late pregnancy, can play a role in preventing the occurrence of neural tube defects. Moreover, previous experiments have also confirmed that high doses of folic acid (4-5mg / d) can maintain the folic acid concentration in the blood at a higher level in a shorter period of time, thereby acting as an "emergency supplement", significantly Reduce the probability of neural tube defects. Therefore, we recommend that women who have not supplemented with folic acid during pregnancy should start taking oral high-dose (5mg / d) folic acid as soon as pregnancy is confirmed, until the end of the 12th week. Such a dose is also safe for pregnant women.
It should be noted that this "emergency supplementation" is only a last resort remedy for the failure to supplement folic acid in a timely manner during pregnancy, and it is generally not recommended for couples during pregnancy.
In summary, starting from 3 months before pregnancy, 400-800 micrograms of folic acid supplemented with multivitamins per day and continuing until the end of lactation are extremely beneficial to the benefits of mothers and infants.
About the author: Han Lei The 306th Hospital of the Chinese People's Liberation Army
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