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You could also send an email to the <a href="https://meta.wikimedia.org/wiki/Special:MyLanguage/Stewards" class="extiw" title="m:Special:MyLanguage/Stewards">stewards</a> <a href="https://meta.wikimedia.org/wiki/Special:MyLanguage/VRT" class="extiw" title="m:Special:MyLanguage/VRT">VRT</a> queue at <kbd>stewards@wikimedia.org</kbd> including all above details.</div></div><hr /> <p>You can view and copy the source of this page. </p><textarea readonly="" accesskey="," id="wpTextbox1" cols="80" rows="25" style="" class="mw-editfont-monospace" lang="en" dir="ltr" name="wpTextbox1">===Human reproduction=== Folic acid is an important nutrient for women who may become Pregnancy|pregnant, because a woman's blood levels of folate fall during pregnancy due to an increased maternal RBC synthesis in the first half of the pregnancy and fetal demands in the second half.<ref name="Barr"/> The first four weeks of pregnancy (when most women do not even realize they are pregnant) require folic acid for proper development of the brain, skull, and spinal cord.<ref name="eatrightontario.ca"/> Serious birth defects like neural tube defects are less likely to occur when women take 0.4&nbsp;mg of folic acid daily.<ref name="eatrightontario.ca"/> Adequate folate intake during the preconception period, the time right before and just after a woman becomes pregnant, helps protect against a number of congenital malformations including neural tube defects (which are the most notable birth defects that occur from folate deficiency).<ref name="Oldref_21">{{cite journal|author=Shaw GM, Schaffer D, Velie EM, Morland K, Harris JA|title=Periconceptional vitamin use, dietary folate, and the occurrence of neural tube defects|journal=Epidemiology|volume=6|issue=3|year=1995|pages=219–226|pmid=7619926|doi=10.1097/00001648-199505000-00005}}</ref> Neural tube defects (NTDs) result in malformations of the spine (spina bifida), skull, and brain (anencephaly). The risk of neural tube defects is significantly reduced when supplemental folic acid is consumed in addition to a healthy diet prior to and during the first month following conception.<ref name="Oldref_22">{{cite journal|author=Mulinare J, Cordero JF, Erickson JD, Berry RJ|title=Periconceptional use of multivitamins and the occurrence of neural tube defects|journal=Journal of the American Medical Association|volume=260|issue=21|year=1988|pages=3141–3145|pmid=3184392|doi = 10.1001/jama.260.21.3141}}</ref><ref name="Oldref_23">{{cite journal|author=Milunsky A, Jick H, Jick SS, Bruell CL, MacLaughlin DS, Rothman KJ, Willett W|title=Multivitamin/folic acid supplementation in early pregnancy reduces the prevalence of neural tube defects|journal=Journal of the American Medical Association|volume=262|issue=20|year=1989|pages=2847–2852|pmid=2478730|doi=10.1001/jama.262.20.2847}}</ref> The protective effect of folate during pregnancy goes beyond NTDs. Supplementation with folic acid has been shown to reduce the risk of congenital heart defects, Cleft lip and palate|cleft lip<ref>Folic acid supplements and risk of facial clefts: national population based case-control study. Wilcox AJ, Lie RT, Solvoll K, Taylor J, McConnaughey DR, Abyholm F, Vindenes H, Vollset SE, Drevon CA. BMJ. 2007 Mar 3;334(7591):464. Epub 2007 Jan 26. PMID: 17259187</ref>, limb defects, and urinary tract anomalies.<ref>Goh YI & Koren G (2008) "Folic acid in pregnancy and fetal outcomes", ''J. Obstet. Gynaecol.'' 28:3–13.</ref> Women who could become pregnant are advised to eat foods fortified with folic acid or take supplements in addition to eating folate-rich foods to reduce the risk of some serious birth defects. Having enough folic acid supplements in the months before pregnancy is very important to prevent neural tube defects.<ref>Wilton DC, Foureur MJ. Women Birth. 2009 Oct 12. A survey of folic acid use in primigravid women.</ref> Taking 400 micrograms of synthetic folic acid daily from fortified foods and/or supplements has been suggested. The RDA for folate equivalents for pregnant women is 600-800 micrograms, twice the normal RDA of 400 micrograms for women who are not pregnant.<ref>[http://www.cdc.gov/ncbddd/folicacid/health_recomm.htm Health Professionals Recommendations, Folic Acid, NCBDDD, CDC]</ref> A study published by Milunski et al. has indicated that women who took folic acid supplements during the course of pregnancy can dramatically reduce the prevalence of infant neural tube defects by 3.9 times. The prevalence had dropped from 3.5 to 0.9 defects per 1000 births.<ref>[http://www.sjsu.edu/faculty/gerstman/eks/Milunsky1989.pdf]</ref> Although the recommended folic acid intake for women planning for pregnancy is 400 micrograms per day, the mechanisms and reasons why folic acid prevents birth defects is unknown.<ref name="Steegers-Theunissen">Steegers-Theunissen RP et al., PLoS One. 2009 Nov 16;4(11):e7845. Periconceptional maternal folic acid use of 400 microg per day is related to increased methylation of the IGF2 gene in the very young child.</ref> It is hypothesized that the insulin-like growth factor 2 gene is differentially methylated and these changes in IGF2 result in improved intrauterine growth and development.<ref name="Steegers-Theunissen"/> Folate deficiency during pregnancy can increase the risk of preterm delivery, infant low birth weight, and fetal growth retardation.<ref name="ReferenceB">Folic acid: influence on the outcome of pregnancy, Scholl TO et al, American Journal of Clinical Nutrition, Vol. 71, No. 5, 1295S-1303s, May 2000</ref> Folate deficiency in the mother increases homocysteine level in the blood which may lead to spontaneous abortion and pregnancy complications such as placental abruption and preeclampsia.<ref name="ReferenceB"/> Recently studies have been conducted to test the hypothesis that folic acid supplementation reduces the risk of childhood acute lymphoblastic leukemia, but evidence so far has been weak.<ref>Milne E et al., Maternal folate and other vitamin supplementation during pregnancy and risk of acute lymphoblastic leukemia in the offspring. Int J Cancer. 2009 Oct 16.</ref> Folic acid may also reduce chromosomal defects in sperm to some extent, which may be relevant for men considering to father a child.<ref name=Youngetal>[http://www.medpagetoday.com/PrimaryCare/DietNutrition/tb/8825 Medical News: Extra Folate for Men May Reduce Birth Defects - in Primary Care, Diet & Nutrition from MedPage Today]; citing S.S. Young et al., [http://www.medpagetoday.com/upload/2008/3/21/den036v1.pdf The association of folate, zinc and antioxidant intake with sperm aneuploidy in healthy non-smoking men]. Human Reproduction pp. 1–9, 2008</ref> A benefit is indicated even for more than 700 mcg folate per day,<ref name=Youngetal/> which though below the tolerable upper intake levels of 1,000&nbsp;µg/day was 1.8 times the recommended dietary allowance. It is estimated that approximately 85% of women use folic acid supplements before they become pregnant but only 18% use enough folic acid supplements to meet the current folic acid requirements due to socio-economic challenges facing some women.<ref>McGuire M, Cleary B, Sahm L, Murphy DJ. Hum Reprod. 2009 Nov 12. Prevalence and predictors of periconceptional folic acid uptake--prospective cohort study in an Irish urban obstetric population.</ref> Folic acid supplements may even protect the fetus against disease when the mother is battling a disease or taking medications or smoking and pregnancy|smoking during pregnancy.<ref>Jia ZL, Li Y, Chen CH, Li S, Wang Y, Zheng Q, Shi B. DNA Cell Biol. 2009 Nov 6. 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