Folic Acid Deficiency

Quick Answer

Folic acid is a naturally occurring B vitamin vital to healthy fetal development. Babies that suffer from folic acid deficiency are at greater risk of specific birth defects — called neural tube defects — that affect the brain and spine. Taking folic acid supplements can help lower this risk.

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What Is Folic Acid Deficiency?

Folic acid affects the development of the neural tube, which is the structure in a developing fetus that eventually forms into the brain, spinal cord, and surrounding tissue. When a pregnant woman does not receive enough folic acid, the neural tube may fail to close. Folic acid deficiency may lead to serious health complications for the child that may even result in death.

Folic acid can be found in leafy greens, citrus fruits, and legumes, as well as enriched foods like bread, pasta, rice, or breakfast cereal. Incorporating these foods may not meet the folic acid content required for a developing fetus. Women who are planning to become pregnant are often advised to take supplements to ensure that their child receives enough of this important nutrient.

Folic Acid and Neural Tube Defects Quick Facts

  • Roughly 300,000 neural tube defects (NTDs) occur worldwide each year.
  • A developing fetus needs 400 micrograms of folic acid daily.
  • Neural tube defects develop in the first 28 days of pregnancy.
  • The most severe neural tube defects include spina bifida and anencephaly.
  • Taking folic acid before and during early pregnancy can prevent up to 70% of NTDs.
  • Some babies born with NTDs need multiple surgeries, lifelong medical care, and ongoing therapy.
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Causes of Folic Acid Deficiency

Deficiency may occur if there is something blocking the absorption of the nutrient or preventing the body from converting it to a usable form.

Factors that can cause folic acid deficiency include:

  • Alcohol Consumption: Drinking alcohol can prevent the proper absorption of folic acid
  • Diet: Not consuming enough fresh fruits, vegetables, and legumes can put mothers and babies at risk
  • Diseases/Illnesses: Crohn’s, celiac, and severe kidney diseases, and some forms of cancer that require dialysis, can all lead to deficiency
  • Genetics: Some people are born with genetic mutations that cause the inability to absorb folic acid
  • Medications: Some medications, such as those used to treat seizures, can lead to folic acid deficiency

When a woman of childbearing age begins to consider starting a family, her doctor should guide her to mitigate all possible risk factors that can lead to folic acid deficiency. Failure to do so could be considered medical negligence and can have dire consequences for both the mother and baby.

– Beth Carter, RN, On-Staff Legal Nurse Consultant Certified

“There are clues that something is wrong. Medical negligence happens when those warning signs are ignored.”

– Beth Carter, RN, On-Staff Legal Nurse Consultant Certified

Folic Acid Deficiency Symptoms

The symptoms of folic acid deficiency vary widely in both presentation and severity. Both the mother and baby can be affected by the absence of this vital nutrient.

Maternal Symptoms

Pregnant women can suffer from a variety of symptoms. While these symptoms can be significant, they are generally temporary and do not lead to long-term complications.

Folic acid deficiency symptoms include:

  • Anemia
  • Decreased appetite
  • Diarrhea
  • Gray hair
  • Irritability
  • Low energy
  • Mouth sores
  • Swollen/tender tongue

Symptoms in Babies

The symptoms of folic acid deficiency are more severe for the child than for the mother. Improper development of the neural tube can lead to a wide variety of birth defects of the brain and spinal cord. The two main types of neural tube defects are spina bifida and anencephaly.

Spina Bifida

Spina bifida occurs when the backbone fails to fully develop, resulting in an unprotected and exposed spinal cord. The severity of spina bifida symptoms can vary depending on the location of the opening where the spinal cord is exposed and if the nerves have been damaged.

Symptoms of spina bifida include:

  • Hydrocephalus (water on the brain)
  • Incontinence
  • Intellectual disability
  • Lack of sensation in extremities
  • Partial paralysis/limited mobility
  • Skin injuries (burns, sores, calluses, blisters)

In spite of these challenges, many individuals with spina bifida go on to live full and active lives with proper support and treatment.

Anencephaly

Anencephaly affects about 1 in 4,600 babies in the United States each year. It occurs when the top of the neural tube fails to close properly during the early stages of pregnancy. Children born with anencephaly are missing parts of the brain and skull.

There is no treatment for anencephaly, and children born with the condition generally die shortly after birth.

Can Folic Acid Deficiency Be Prevented?

Yes, folic acid deficiency is preventable. A simple blood test can determine if a woman is at risk for folic acid deficiency. Additionally, most neural tube defects can be diagnosed before birth with proper screening.

The neural tube develops in the first few weeks of pregnancy, often before the mother knows she is pregnant. The first prenatal visit generally occurs 6-12 weeks into a pregnancy. By this time, it may be too late to take preventive measures against neural tube defects.

Women of childbearing age who are interested in having children should begin taking folic acid supplements before they become pregnant.

Doctors have a duty to help their patients manage all relevant risk factors with proper testing and screening. When this duty of care is breached, it can have devastating, lifelong consequences for children and families.

Get Legal Help for Medical Negligence

Pregnancy is a delicate and demanding experience, where seemingly small oversights can have big consequences. Something as simple as not being told to take the right kind of vitamins can affect both mother and baby in serious, long-term ways.

If your family has been affected by folic acid deficiency resulting in a birth injury, you may be entitled to financial compensation. Get a free case review to learn more about pursuing legal action.

Birth Injury Support TeamLast modified:
Reviewed by:Beth Carter, RN

Registered Nurse, Legal Nurse Consultant Certified

  • Fact-Checked
  • Editor

Beth Carter has over 18 years of experience as a Registered Nurse. She spent nearly half of that time working in labor and delivery units. This, combined with her own experience giving birth to a premature baby, ignite Beth’s passion for helping new mothers access the information and resources they deserve.

The Birth Injury Justice Center was founded in 2003 by a team of legal professionals to educate and empower victims and families affected by birth injuries. Our team is devoted to providing you with the best resources and legal information for all types of birth injuries.

  1. Centers for Disease Control and Prevention. (CDC). (2024). Facts about Anencephaly. Retrieved from https://www.cdc.gov/birth-defects/about/anencephaly.html.
  2. CDC. (n.d.). Folic acid and neural tube Defects resources. Retrieved from https://www.cdc.gov/folic-acid/communication-resources/.
  3. CDC. (2024). Living with spina bifida. Retrieved from https://www.cdc.gov/spina-bifida/living-with/index.html.
  4. Johns Hopkins Medicine. (n.d.). Folate-deficiency anemia. (n.d.). Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/folate-deficiency-anemia.
  5. Mayo Clinic. (2023). Spina bifida. Retrieved from https://www.mayoclinic.org/diseases-conditions/spina-bifida/symptoms-causes/syc-20377860.
  6. Mayo Clinic. (2020). Women’s wellness: Folic acids and other ways to help avoid birth defects. Retrieved from https://newsnetwork.mayoclinic.org/discussion/womens-wellness-folic-acids-and-other-ways-to-help-avoid-birth-defects/.