Folate in Pregnancy
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Folate in Pregnancy
The recommended serum folate level during pregnancy varies based on the trimester. During the first, second, and third trimesters, the recommended serum folate levels are 2.6-15 ng/mL, 0.8-24 ng/ml, and 1.4-20.7 ng/mL, respectively (Zou et al., 2021). The World Health Organization recommends red blood cell folate concentrations above 400 ng/mL during pregnancy (Jankovic-Karasoulos et al., 2021).
Women ensure appropriate folate levels during pregnancy by taking folate supplements and eating folate fortified food and folate-rich food. The CDC recommends a daily dose of 400 mcg of folic acid for pregnant and reproductive-age women intending to get pregnant. Folate-rich foods recommended for women include cabbage, broccoli, spinach, brussels sprouts, lettuce, nuts, eggs, apple, avocados, grapefruit, oranges, soya beans, lima beans, and lentils (Molloy et al., 2020).
Flote serves as a coenzyme in single carbon metabolism and amino acid interconversion. As a result, folate is required to synthesize thymidylate and purines (Jankovic-Karasoulos et al., 2021). As a result, folate is essential for DNA synthesis by the rapidly replicating and dividing cells of the fetus. Folate deficiency in pregnancy is associated with an increased risk of neural tube defects (NTDs) such as spina bifida, anencephaly, and encephalocele. Folate deficiency also increases the risk of cleft lip and palate, congenital heart disease (CHD), low birth weight, and prematurity (Zou et al., 2021).
I will first introduce myself to the patient and obtain consent at the beginning of the education session. I will then inquire what my patients know regarding folate and its importance to fetal development. This question will enable me to identify knowledge gaps. As a result, I will personalize my education to address this gap. I will then inform my patient that folate is a water-soluble vitamin required to synthesize DNA during fetal development. I will use diagrams to educate the patient on the consequences of folate deficiency, such as NTDS, CHDs, cleft lip and palate, and low birth weight. I will inform the client that the risk of these defects can be reduced by taking 400 mcg of folate supplement daily, eating folate fortified food, and folate-rich food, such as cabbage, broccoli, spinach, brussels sprouts, lettuce, nuts, eggs, apple, avocados, grapefruit, oranges, soya beans, lima beans, and lentils. I will then address any questions that the patient may have. Finally, I will thank the patients for their time.
References
Jankovic-Karasoulos, T., Furness, D. L., Leemaqz, S. Y., Dekker, G. A., Grzeskowiak, L. E., Grieger, J. A., Andraweera, P. H., McCullough, D., McAninch, D., McCowan, L. M., Bianco-Miotto, T., & Roberts, C. T. (2021). Maternal folate, one-carbon metabolism and pregnancy outcomes. Maternal & Child Nutrition, 17(1), e13064. https://doi.org/10.1111/mcn.13064
Molloy, J., Collier, F., Saffery, R., Allen, K. J., Koplin, J. J., Louise Ponsonby, A., Tang, M. L. K., Ward, A. C., Martino, D., Burgner, D., Carlin, J. B., Ranganathan, S., Symeonedies, C., Dwyer, T., BIS Investigator Group, & Vuillermin, P. (2020). Folate levels in pregnancy and offspring food allergy and eczema. Pediatric Allergy and Immunology: Official Publication of the European Society of Pediatric Allergy and Immunology, 31(1), 38–46. https://doi.org/10.1111/pai.13128
Zou, R., El Marroun, H., Cecil, C., Jaddoe, V. W. V., Hillegers, M., Tiemeier, H., & White, T. (2021). Maternal folate levels during pregnancy and offspring brain development in late childhood. Clinical Nutrition (Edinburgh, Scotland), 40(5), 3391–3400. https://doi.org/10.1016/j.clnu.2020.11.025