increased risk of neural tube defects with overweight mamas?

[MamaKickyPants]

We are ttc # 2 right now, but this isn't really a fertility qeustion and I'm hoping I'll get more opinions over here.

My mom is a midwife, so she usually knows what she's talking about, but she told me this morning that I should be taking 5 mg of folic acid b/s I'm at higher risk of neural tube defects b/c I'm overweight. I'm 5'9" and 230 lbs, so definitely heavier, but I'm in good shape and get lots of exercise, try to eat healthy, etc.

My pregnancy with DS was completely uncomplicated, I was about 40 lbs lighter when I got pregnant with him, but gained a LOT (over 70lbs!) and didn't lose it all afterwards.

I'm just wary of anything that says 'increased risk due to being overweight/obese.' I know there are some legit risks, I just want to know if anyone has read anything about this. Not that I have an issue taking more folic acid, and maybe it just bugged me cause it came from my mom and she always has these 'helpful' suggestions related to my weight, eating etc but that end up being pretty judgy, I feel. Is she being a good midwife? or an annoying mom?

[MaerynPearl]

http://www.ncbi.nlm.nih.gov/pubmed/17594408

perhaps she read this and misunderstood it?

It doesn't say we need more, but that we are more likely to need to add it in the first place because we are not already getting it.

As in, be sure obese women take it because they are less likely to already be taking it.

Its odd, but yeah, whatever!


However, yes, if you are not taking folic acid (or getting enough in your diet) already, be sure to start. Its best to start it while TTC rather than after your BFP!

[MamaKickyPants]

Thanks! That may be what she was looking at, I'll check. I have been taking 2.5 mg of folic acid for a while, so no problem there, but just thought that 5 seemed like a lot!

[Ruthla]

In other words, obese women are more likely to be "women who overall aren't taking care of themselves" and aren't eating leafy greens or taking multivitamins?

When I was pg with DS 9 years ago, I was told "400 mcg of folic acid when not pg and 800 mcg while pg." That's under a gram- 5 grams does sound like a LOT! Even 2.5 grams a day sounds like you're more than covering your bases.

[SumnerRain]

When I discovered I was pg and I was not taking a prenatal, just a regular multivit my OB prescribed 1mg of Folic Acid.... when it came time for a refil I told him I was getting 800mcg between my regular vitamins, do I need to add more he said 800mcg was plenty (and he knows that I am 70+ lbs overweight).

Just my anecdotal 2c. My m/w also agrees 800mcg is enough.

[tanyalynn]

May I suggest you look into the difference between folic acid and folate? Not everyone changes folic acid into folate well, and some of the groups of people who have been rec'd high dose folic acid have a genetic variant that is involved here. It's their MTHFR gene (funny acronym, but real) and it's not shockingly rare, it's fairly common really, though a minority of people.

Some prenatals have actual folate instead of folic acid, Thorne brand is available lots of places online and tends to have good forms of vitamins and minerals, including folate.