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What dose of folic acid for a 30 year old primigravida whose sister died in infancy from a neural tube defect, whose mother was on anticonvulsants?

Associated tags: Child health, family history, folic acid, neural tube defect, Neurology, preconception care

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Question answered:04/03/08

CKS have a guideline on pre-conception advice [1]. With regard to folic acid it reports:

“What advice should I give a woman planning pregnancy regarding folic acid?

Assess the risk of a neural tube defect (NTD) for a couple planning a pregnancy.

Couples are at high risk of conceiving a child with an NTD if:
- Either partner has an NTD, or they have had a pregnancy affected by an NTD.
- The woman has coeliac disease, diabetes, sickle-cell anaemia, or is taking antiepileptic drugs.

All other people have a normal risk for an NTD.

Recommend women who are at high risk of an NTD to take folic acid 5 mg daily and, once pregnant, to continue this until the twelfth week of pregnancy.

Recommend women who are at low risk for an NTD to take folic acid 400 micrograms daily and, once pregnant, to continue this until the twelfth week of pregnancy.

Recommend women with sickle-cell anaemia to continue taking their normal dose of folic acid 5 mg daily, and to continue this throughout pregnancy.”

References

1) http://cks.library.nhs.uk/pre_conception_advice_and_management/view_whole_topic_review

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