Folate is a generic term for a water-soluble B-complex
vitamin which plays an important role in
protein synthesis and metabolism and other processes related to cell multiplication and tissue growth. Pregnant and lactating women are at increased risk of
folic acid deficiency because generally their dietary
folate is insufficient to meet their physiological requirements and the metabolic demands of the growing fetus. The evidence pertaining to the reduction of the risk of
neural tube defects (NTDs) due to
folate is so compelling that supplementation with 400 μg of
folic acid to all women trying to conceive until 12 weeks of pregnancy has been recommended by every relevant authority. A recent Cochrane review has also found protective effects of
folate supplementation in occurrence and reoccurrence of NTDs. Despite food fortification and targeted public health campaigns promoting
folic acid supplementation, 4,300,000 new cases occur each year worldwide resulting in an estimated 41,000 deaths and 2.3 million disability-adjusted life years (DALYS). This article will review the burden and risk factors of NTDS, and the role of
folate in preventing NTDs. It will also describe different modes of supplementing
folate and the newer evidence of the effectiveness of adding
folate in
oral contraceptives for raising serum and red blood cell
folate levels.