Peran suplementasi asam folat pada masa kehamilan sebagai strategi preventif terhadap risiko neural tube defects
DOI: https://doi.org/10.33024/hjk.v19i7.1082
Asam Folat Kehamilan Neural Tube Defects Suplementasi
Abstract
Background: Neural tube defects (NTDs) are congenital abnormalities of the central nervous system that result from failure of the neural tube to close during embryonic development. They can cause permanent disability or death, and are a significant public health problem, especially in developing countries.
Purpose: To review the role of folic acid supplementation during pregnancy as a preventive strategy against the risk of neural tube defects.
Method: This study was a literature review using the narrative method. Selected articles published between 2020 and 2025 were reviewed, obtained from PubMed and ScienceDirect databases.
Results: Folic acid consumption of 400 microgram per day can reduce the risk of NTDs by 50-70%. However, public compliance with folic acid consumption remains low due to lack of awareness, limited access, and lack of mandatory fortification policies in many countries. In addition, education and socioeconomic factors affect the level of knowledge and supplement consumption.
Conclusion: Folic acid supplementation is an effective preventive strategy in reducing the incidence of NTDs. In addition to preventing NTDs, folic acid supplementation during pregnancy can reduce the risk of pregnancy complications and support fetal development.
Keywords: Folic Acid; Neural Tube Defects; Pregnancy; Supplementation.
Pendahuluan: Neural Tube Defects (NTD) adalah kelainan bawaan pada sistem saraf pusat yang terjadi akibat kegagalan penutupan tabung saraf selama perkembangan embrio. Kelainan ini dapat menyebabkan kecacatan permanen atau kematian, dan menjadi masalah kesehatan masyarakat yang signifikan, terutama di negara berkembang.
Tujuan: Untuk mereview peran suplementasi asam folat pada masa kehamilan sebagai strategi preventif terhadap risiko neural tube defects (NTD).
Metode: Penelitian ini merupakan literature review dengan metode naratif. Dikaji beberapa artikel terpilih yang dipublikasikan antara tahun 2020 hingga 2025, diperoleh dari basis data PubMed dan ScienceDirect.
Hasil: Menunjukkan bahwa konsumsi asam folat sebesar 400 mikrogram per hari dapat menurunkan risiko NTD hingga 50-70%. Namun, tingkat kepatuhan masyarakat terhadap konsumsi asam folat masih rendah karena kurangnya kesadaran, akses terbatas, dan minimnya kebijakan fortifikasi wajib di banyak negara. Selain itu, faktor pendidikan dan sosial ekonomi memengaruhi tingkat pengetahuan dan konsumsi suplemen.
Simpulan: Suplementasi asam folat merupakan strategi preventif yang efektif dalam menurunkan angka kejadian NTD. Selain dapat mencegah NTD, suplementasi asam folat pada masa kehamilan dapat menurunkan risiko komplikasi kehamilan dan mendukung perkembangan janin.
Kata Kunci: Asam Folat; Kehamilan; Neural Tube Defects; Suplementasi.
Downloads
References
Abate, B. B., Kumsa, H., Kibret, G. A., Wodaynew, T., Habtie, T. E., Kassa, M., & Azmeraw, M. (2025). Preconception Folic Acid and Multivitamin Supplementation for the Prevention of Neural Tube Defect: An Umbrella Review of Systematic Review and Meta-analysis. Neuroepidemiology, 59(4), 412-425.
Ars, C. L., Nijs, I. M., Marroun, H. E., Muetzel, R., Schmidt, M., Steenweg-de Graaff, J., & White, T. (2019). Prenatal folate, homocysteine and vitamin B12 levels and child brain volumes, cognitive development and psychological functioning: the Generation R Study. British Journal of Nutrition, 122(s1), S1-S9.
Berry, R. J., Li, Z., Erickson, J. D., Li, S., Moore, C. A., Wang, H., ... & Correa, A. (1999). Prevention of neural-tube defects with folic acid in China. New England journal of medicine, 341(20), 1485-1490.
Blanc-Petitjean, P., Jezequel, M., Manunta, A., Olivari-Philiponnet, C., Samson, E., & Bajeux, E. (2024). Folic acid supplementation use during the peri-conceptional period among professionals of a hospital in France. Preventive Medicine Reports, 38, 102568.
Caffrey, A., McNulty, H., Rollins, M., Prasad, G., Gaur, P., Talcott, J. B., & Pentieva, K. (2021). Effects of maternal folic acid supplementation during the second and third trimesters of pregnancy on neurocognitive development in the child: an 11-year follow-up from a randomised controlled trial. BMC medicine, 19(1), 73.
Cao, R., Xie, J., & Zhang, L. (2022). Abnormal methylation caused by folic acid deficiency in neural tube defects. Open Life Sciences, 17(1), 1679-1688.
Conrad, A., Burns, J., Sherburne, L., Kaled, M. D., Souley, H., & Nielsen, J. (2024). Understanding behavioural drivers of iron and folic acid supplementation and vitamin A-and iron-rich food consumption among women and adolescent girls in Niger. Public Health Nutrition, 27, e249.
Copp, A. J., & Greene, N. D. (2013). Neural tube defects—disorders of neurulation and related embryonic processes. Wiley Interdisciplinary Reviews: Developmental Biology, 2(2), 213-227.
Dai, C., Fei, Y., Li, J., Shi, Y., & Yang, X. (2021). A novel review of homocysteine and pregnancy complications. BioMed research international, 2021(1), 6652231.
De La Fournière, B., Dhombres, F., Maurice, P., de Foucaud, S., Lallemant, P., Zérah, M., ... & Jouannic, J. M. (2020). Prevention of neural tube defects by folic acid supplementation: a national population-based study. Nutrients, 12(10), 3170.
Desta, M., Kassie, B., Chanie, H., Mulugeta, H., Yirga, T., Temesgen, H., ... & Merkeb, Y. (2019). Adherence of iron and folic acid supplementation and determinants among pregnant women in Ethiopia: a systematic review and meta-analysis. Reproductive health, 16(1), 182.
Ebara, S. (2017). Nutritional role of folate. Congenital anomalies, 57(5), 138-141.
Ferrazzi, E., Tiso, G., & Di Martino, D. (2020). Folic acid versus 5-methyl tetrahydrofolate supplementation in pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology, 253, 312-319.
Greene, N. D., & Copp, A. J. (2014). Neural tube defects. Annual review of neuroscience, 37(1), 221-242.
Hasan, T., Arora, R., Bansal, A. K., Bhattacharya, R., Sharma, G. S., & Singh, L. R. (2019). Disturbed homocysteine metabolism is associated with cancer. Experimental & molecular medicine, 51(2), 1-13.
Hiraoka, M., & Kagawa, Y. (2017). Genetic polymorphisms and folate status. Congenital anomalies, 57(5), 142-149.
Isaković, J., Šimunić, I., Jagečić, D., Hribljan, V., & Mitrečić, D. (2022). Overview of neural tube defects: gene–environment interactions, preventative approaches and future perspectives. Biomedicines, 10(5), 965.
Jankovic‐Karasoulos, T., Furness, D. L., Leemaqz, S. Y., Dekker, G. A., Grzeskowiak, L. E., Grieger, J. A., ... & Roberts, C. T. (2021). Maternal folate, one‐carbon metabolism and pregnancy outcomes. Maternal & child nutrition, 17(1), e13064.
Joubert, B. R., Den Dekker, H. T., Felix, J. F., Bohlin, J., Ligthart, S., Beckett, E., ... & London, S. J. (2016). Maternal plasma folate impacts differential DNA methylation in an epigenome-wide meta-analysis of newborns. Nature communications, 7(1), 10577.
Kancherla, V. (2023). Neural tube defects: a review of global prevalence, causes, and primary prevention. Child's Nervous System, 39(7), 1703-1710.
Linnell, A., Murphy, N., Godwin, J., & Cremona, A. (2022). An evaluation of adherence to folic acid supplementation in pregnant women during early gestation for the prevention of neural tube defects. Public Health Nutrition, 25(11), 3025-3035.
Liu, C., Liu, C., Wang, Q., & Zhang, Z. (2018). Supplementation of folic acid in pregnancy and the risk of preeclampsia and gestational hypertension: a meta-analysis. Archives of gynecology and obstetrics, 298(4), 697-704.
Lu, X., Yang, S., Jie, M., Wang, S., Sun, C., Wu, L., ... & Wang, L. (2022). Folate deficiency disturbs PEG10 methylation modifications in human spina bifida. Pediatric Research, 92(4), 987-994.
McComb, J. G. (2015). A practical clinical classification of spinal neural tube defects. Child's Nervous System, 31(10), 1641-1657.
Menezo, Y., Elder, K., Clement, A., & Clement, P. (2022). Folic acid, folinic acid, 5 methyl tetrahydrofolate supplementation for mutations that affect epigenesis through the folate and one-carbon cycles. Biomolecules, 12(2), 197.
Mette M. Berger, Alan Shenkin, Anna Schweinlin, Karin Amrein, Marc Augsburger, Hans-Konrad Biesalski, Stephan C. Bischoff, Michael P. Casaer, Kursat Gundogan, Hanna-Liis Lepp, Angelique M.E. de Man, Giovanna Muscogiuri, Magdalena Pietka, Loris Pironi, Serge
Rezzi, Cristina Cuerda (2022). ESPEN micronutrient guideline. Clinical Nutrition, 41(6), 1357–1424. Diakses dari: https://www.espen.org/files/ESPEN-Guidelines/ESPEN_micronutrient_guideline.pdf
Mida, L. A., Della Zazzera, V., & Fontaine-Bisson, B. (2021). Knowledge, attitude and practice of physicians regarding periconceptional folic acid for women at low risk of a neural tube defect affected pregnancy. Preventive Medicine Reports, 22, 101327.
Mitchell, L. E. (2005). Epidemiology of neural tube defects. In American journal of medical genetics Part C: seminars in medical genetics (Vol. 135, No. 1, pp. 88-94). Hoboken: Wiley Subscription Services, Inc., A Wiley Company.
Nakkeeran, K. P., Jitender, A., Thulasiraman, S., Krishnan, V., & Muthalagappan, P. L. (2025). Early cognizance of folic acid supplementation among pregnant women in the prevention of cleft lip and palate-a questionnaire study. Journal of Oral Biology and Craniofacial Research, 15(2), 421-427.
Parazzini, F., Mauri, P. A., Esposito, G., Agangi, A., Iannantuoni, S., Motta, M., ... & Maruotti, G. M. (2025). Epidemiology of folic acid/folates use in the preconceptional period and during pregnancy in Italy: results from a cross-sectional observational study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 310, 113967.
Tian, T., Lai, X., Xiang, K., Han, X., Yin, S., Cabrera, R. M., ... & Ren, A. (2022). Hypermethylation of PI3K-AKT signalling pathway genes is associated with human neural tube defects. Epigenetics, 17(2), 1878725.
Vos, T., Lim, S. S., Abbafati, C., Abbas, K. M., Abbasi, M., Abbasifard, M., ... & Bhutta, Z. A. (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The lancet, 396(10258), 1204-1222.
Wang, L., Wang, F., Guan, J., Le, J., Wu, L., Zou, J., ... & Zhang, T. (2010). Relation between hypomethylation of long interspersed nucleotide elements and risk of neural tube defects. The American journal of clinical nutrition, 91(5), 1359-1367.
Wang, X., Yu, J., & Wang, J. (2023). Neural tube defects and folate deficiency: is DNA repair defective?. International journal of molecular sciences, 24(3), 2220.
Williams, J., Mai, C. T., Mulinare, J., Isenburg, J., Flood, T. J., & Ethen, M. (2015). Updated estimates of neural tube defects prevented by mandatory folic acid fortification—United States, 1995–2011. MMWR Morb Mortal Wkly Rep, 64(1), 1-5.
Wilson, R. D., & O’Connor, D. L. (2022). Guideline No. 427: folic acid and multivitamin supplementation for prevention of folic acid–sensitive congenital anomalies. Journal of Obstetrics and Gynaecology Canada, 44(6), 707-719.
World Health Organization. (2015). Global health estimates (GHE)–Cause-specific mortality. 2015. Diakses dari: https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/ghe-leading-causes-of-death
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Holistik Jurnal Kesehatan
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
