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Supplementations in pregnancy/ pre-conception

Folic acid for prevention of neural tube defects
for all women who could become pregnant

Folic acid 400 microgram tablets

Advise to purchase OTC

Dose: Women at low risk of neural tube defects, 400micrograms daily until week 12 of pregnancy
high risk neural tube defectsFolic acid 5mg tablets

Dose: Women at high risk of neural tube defects (see prescribing notes), including those with diabetes or a BMI of 30 and above, 5mg daily until week 12 of pregnancy

Vitamin D

Vitamin D

Encourage ALL pregnant women to take 10micrograms of Vitamin D throughout pregnancy and whilst breastfeeding.

Advise to purchase OTC

See section 9.6.4

Prescribing Notes

Folic acid supplements taken before and during pregnancy can reduce the occurrence of neural tube defects. The risk of a neural tube defect occurring in a child should be assessed and folic acid given as follows:

  • Women at a low risk of conceiving a child with a neural tube defect(NTD) should be advised to take folic acid as a medicinal or food supplement at a dose of 400 micrograms daily before conception and until week 12 of pregnancy. Women who have not been taking folic acid and who suspect they are pregnant should start at once and continue until week 12 of pregnancy.
  • Women at high risk* of neural tube defects who wish to become pregnant (or who are at risk of becoming pregnant) should be prescribed folic acid 5mg daily and continue until week 12 of pregnancy. Women with sickle-cell disease, thalassaemia or thalassaemia trait should take folic acid 5mg throughout pregnancy.

*High risk may include if:

    • Either partner has an NTD, they have had a previous pregnancy affected by an NTD, or they have a family history of an NTD.
    • The woman is taking anti–epileptic medication or certain anti-retroviral medication for HIV
    • The woman has diabetes mellitus, sickle cell anaemia, or thalassaemia.
    • The woman is obese (BMI of 30 and above)