PEBC MCQ Special Populations & Other Therapeutics question: folic acid supplementation

PEBC MCQSpecial Populations & Other Therapeutics

AJ, 29, healthy, with no history of neural tube defects, plans to conceive in the next few months. What folic acid supplementation does SOGC recommend?

a. 1 mg folic acid weekly, starting in the second trimester
b. 5 mg folic acid daily, starting only once the pregnancy is confirmed
c. A multivitamin with 0.4 mg folic acid daily, before conception
d. No supplement if she eats a balanced diet

Show the answer and explanation

Answer: c. A multivitamin with 0.4 mg folic acid daily, before conception

For people at low risk, SOGC recommends a daily multivitamin containing 0.4 mg folic acid starting at least 2-3 months before conception and continuing through pregnancy and breastfeeding, because the neural tube closes by about 28 days after conception, often before pregnancy is recognised. Higher doses are for higher-risk groups (such as previous NTD, some antiseizure drugs or diabetes). Diet alone is not considered sufficient. Source: Wilson RD, O'Connor DL. SOGC Guideline No. 427, Folic acid and multivitamin supplementation for prevention of folic acid-sensitive congenital anomalies (J Obstet Gynaecol Can 2022;44:707).

Common mistake

Starting folic acid only after pregnancy is confirmed.

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