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April 1, 1968

Folic Acid in Pregnancy

JAMA. 1968;204(1):79. doi:10.1001/jama.1968.03140140081027

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To the Editor:—  Eight years have elapsed since Eastman asked why "such a fuss" should be raised about folic acid in pregnancy (Obstet Gynec Survey15:22, 1960). It is alarming that his question remains critically unanswered.Recent studies continue to associate folate deficiency with pregnancy pathological conditions. Many sources propose routine administration of the vitamin during antepartum care. The lay press is beginning to comment, and pharmaceutical companies are now inserting folic acid into prenatal multivitamin capsules.Until lately, we have not been adequately exposed to more reserved comment that questions the role of this isolated nutritional defect as a proximate cause of reproductive casualty. Folic acid deficiency anemia in pregnancy, caused by defects in ingestion, use, and by increased demand for the vitamin, is well defined. The socioeconomically deprived (ingestion defect) multiparous epileptic receiving anticonvulsant therapy (malutilization) and bearing twins (increased demand) is a prime candidate for both