A midwife tells a client who is trying to get pregnant to eat fresh fruits and green and leafy vegetables before conceiving. The midwife also recommends 400 mcg of folic acid a day. Once she gets pregnant, the midwife may recommend that the client increase her folic acid intake to 600 mcg per day during the first trimester. Which of the following is not a benefit of folic acid supplementation before and during pregnancy?
  1. It prevents the formation of large but ineffective red blood cells.
  2. It prevents neural tube defects.
  3. It decreases the baby’s risk for cleft lip or palate.
  4. It ensures proper functioning of the thyroid gland.
Explanation
Answer: D - Iodine, not folic acid, improves thyroid function. The other options are all benefits of folic acid supplementation. As the blood volume doubles during pregnancy, the body’s need for folic acid increases. Without supplementation, the mother may develop megaloblastic anemia, which is manifested by the formation of large but ineffective red blood cells. Folic acid is essential for the production, repair and functioning of DNA. Folic acid deficiency may cause neural tube defects and other birth defects like cleft lip, cleft palate and heart defects.
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