Folate (vitamin B9) is crucial during pregnancy as it is necessary for the proper development of the fetal neural tube, which eventually forms the brain and spinal cord. Additionally, as cells rapidly divide and multiply during pregnancy, a sufficient supply of folate is necessary to ensure that DNA is replicated accurately. This is particularly important in the early stages of fetal development when the embryo is rapidly growing. Ensuring that sufficient folate is available and proper folate transport is undisturbed is vital.
Folate receptor alpha (FRa), a major transporter of folate, is extensively expressed on the placenta. This high expression of FRÉ‘ on the placenta is a critical part of ensuring that the developing fetus receives an adequate supply of folate, which is essential for proper growth and development.
Folate receptor autoantibodies are known to make the folate receptor alpha (FRa) dysfunctional, thereby potentially disrupting adequate folate transport. This may present a problem for overall folate transport into cells. Screening for folate receptor autoantibodies in pregnancy (or even pre-pregnancy), with the use of FRAT IgG, is advisable.