Folate is a naturally occurring essential vitamin (vitamin B9) found in fruit, green leafy vegetables, grains and legumes.1 It is important in DNA and RNA synthesis and acts as an enzyme cofactor in the assembly of nucleic acids and amnio acids.1 Folic acid refers to a synthetic form, which is converted to folate following its consumption.1 Sufficient folate levels can only be achieved from satisfactory dietary intake or supplementation. Folate deficiency can be associated with other vitamin and mineral deficiencies. Certain public health systems (including the UK) have fortified certain foods (eg, breads, cereals) with folic acid. The aim is to reduce the risks of folate deficiency in pregnancy,2 as pregnancy is often unplanned and adherence to national folic acid supplementation guidelines is typically low. Pregnancy increases folate requirements, due to increased metabolic demands and fetal growth. Folate deficiency in pregnancy can result in anaemia in the mother, placental health issues, increased risk of early fetal loss, premature birth, fetal growth restriction and pre-eclampsia.3 Folate deficiency in pregnant mothers also significantly increases the risk of neural tube defects, other major congenital malformations and neurodevelopmental disorders including autism spectrum disorder.4 Putative mechanisms involve interference with DNA and RNA synthesis and biochemical pathway alterations, resulting in excess toxic metabolites. The WHO recommends daily supplementation with 0.4 mg of folic acid to women in the general population who are planning a pregnancy or who are already pregnant to minimise the risks of malformations.5 A meta-analysis, which included one randomised controlled trial and three cohort studies, concluded that supplementation with lower doses of folic acid reduces the risk of neural tube defect by 62% in the general population.6 Based on the results of three randomised controlled trials, the same authors reported that supplementation with higher doses …

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女性癫痫患者的叶酸：处方建议

叶酸是一种天然存在的必需维生素（维生素 B9），存在于水果、绿叶蔬菜、谷物和豆类中。1 它在 DNA 和 RNA 合成中很重要，并且在核酸和氨基酸组装中充当酶辅助因子。1 叶酸叶酸是指合成形式，食用后会转化为叶酸。1 只有通过令人满意的饮食摄入或补充才能达到足够的叶酸水平。叶酸缺乏可能与其他维生素和矿物质缺乏有关。某些公共卫生系统（包括英国）已在某些食品（例如面包、谷物）中强化了叶酸。其目的是降低怀孕期间叶酸缺乏的风险2，因为怀孕往往是无计划的，而且对国家叶酸补充指南的遵守率通常较低。由于代谢需求增加和胎儿生长，怀孕会增加叶酸需求。怀孕期间叶酸缺乏会导致母亲贫血、胎盘健康问题、早期流产、早产、胎儿生长受限和先兆子痫的风险增加。3怀孕母亲叶酸缺乏还会显着增加神经管缺陷、其他主要先天畸形和神经发育障碍，包括自闭症谱系障碍。4 假定的机制涉及 DNA 和 RNA 合成的干扰以及生化途径的改变，导致有毒代谢物过量。世界卫生组织建议普通人群中计划怀孕或已怀孕的女性每天补充 0.4 毫克叶酸，以尽量减少畸形风险。5 一项荟萃分析，其中包括一项随机对照试验和三项队列研究，得出的结论是，补充较低剂量的叶酸可将一般人群中神经管缺陷的风险降低 62%。6 根据三项随机对照试验的结果，同一作者报告说，补充较高剂量的叶酸……