A patient planning pregnancy asks about nutritional supplements. What is the recommended daily folic acid intake?

• A. 400 to 800 mg of folic acid per day
• B. 400 to 800 micrograms of folic acid per day
• C. 1000 to 1200 mg of folic acid per day
• D. 0 mg of folic acid

Answer: (A)

Folic acid before conception helps prevent neural tube defects by supporting early fetal neural development, which occurs very early in pregnancy. For someone planning pregnancy, the recommended daily intake is about 400 to 800 micrograms (0.4–0.8 mg) of folic acid. It’s important to use the microgram unit here—400–800 mg would be far far more than needed and could cause problems. Most women meet this need with a prenatal vitamin containing 400 mcg of folic acid daily, and the amount is typically increased to about 600 mcg per day during pregnancy. Higher doses, such as 4 mg daily, are reserved for specific risk factors or a prior neural tube defect pregnancy under clinician guidance.