Scientists compared multivitamins with folic acid to folic acid alone to see which better prevents neural tube defects—serious birth defects affecting the brain and spine. Using mouse models and human lab-grown tissue, researchers found that multivitamins were more effective at keeping cells balanced and healthy during early development. While folic acid alone helped fix some problems, it also made cells divide too quickly and created imbalances in important building blocks. Multivitamins maintained normal, healthy cell activity. These findings suggest that the combination of vitamins and minerals in multivitamins may offer better protection than folic acid by itself during pregnancy.
The Quick Take
- What they studied: Whether taking a multivitamin with minerals is better than taking just folic acid for preventing neural tube defects (birth defects of the brain and spine)
- Who participated: The study used mice with genetic conditions that make them prone to neural tube defects, plus human tissue grown in the lab that mimics early brain and spine development
- Key finding: Multivitamins were more effective than folic acid alone at preventing neural tube defects in mice and keeping cells healthy and balanced in lab-grown human tissue. Folic acid alone sometimes caused cells to divide too quickly and created chemical imbalances
- What it means for you: If you’re pregnant or planning to become pregnant, this research suggests taking a complete prenatal multivitamin may offer better protection than folic acid supplements alone. However, always follow your doctor’s recommendations, as this research is still in early stages and needs human studies to confirm these findings
The Research Details
Researchers used two main approaches to test their question. First, they studied mice that had genetic problems making them resistant to folic acid or actually harmed by it. They compared what happened when these mice received multivitamins versus folic acid alone. Second, they grew human tissue in the lab that resembles the early neural tube (the structure that becomes the brain and spine). They created problems in this tissue and then treated it with either multivitamins or folic acid to see which worked better at fixing the issues.
The researchers used advanced techniques to measure what was happening inside the cells. They looked at cell structure, how fast cells were dividing, and the levels of important chemical building blocks (nucleotides) that cells need to function. They used a special machine called HPLC to measure these chemicals precisely.
This approach allowed them to study the problem at multiple levels—in whole organisms (mice), in human-like tissue, and at the chemical level inside cells. This multi-level approach helps researchers understand not just whether something works, but how and why it works.
This research matters because neural tube defects are serious birth defects that affect thousands of babies each year. Current recommendations focus on folic acid alone, but this study suggests the full picture might be more complex. By testing in both mice and human tissue, researchers could see how different supplements affect the actual developing tissue. The chemical analysis revealed that folic acid and multivitamins work through different mechanisms—folic acid alone can actually cause problems with cell division speed and chemical balance, while multivitamins maintain healthy balance. Understanding these differences could lead to better prevention strategies.
This research has both strengths and limitations. Strengths include using multiple study systems (mice and human tissue), measuring multiple outcomes (cell structure, division rates, chemical levels), and using precise measurement techniques. The human tissue was specifically designed to mimic early neural tube development, making it relevant to the real problem. However, the study was done in lab conditions, not in living pregnant people, so results may not directly translate to humans. The mouse models had genetic conditions that may not represent typical human pregnancies. More research in actual human pregnancies would be needed to confirm these findings apply to real-world prevention.
What the Results Show
In mice with genetic problems, multivitamins prevented neural tube defects better than folic acid alone. Some mice that didn’t respond well to folic acid actually benefited from multivitamins instead. In the human tissue grown in the lab, both multivitamins and folic acid could fix abnormal cell structures and restore normal cell organization when problems were created. However, the way they worked was different.
When researchers looked at cell division rates, folic acid alone caused cells to divide much faster than normal—like pressing the accelerator too hard. Multivitamins kept cell division at healthy, normal speeds. This is important because cells dividing too fast during early development can cause problems. When researchers measured the chemical building blocks cells use (nucleotides), folic acid created a lot of variation and imbalance in these chemicals. Multivitamins kept these chemicals stable and balanced, similar to healthy control tissue.
The researchers discovered that a specific chemical called thymine was reduced when cells received folic acid alone. When they added extra thymine to cells treated with folic acid, it slowed down the excessive cell division and improved the results. This finding suggests that folic acid’s side effect of reducing thymine is part of why it causes problems.
The study found that multivitamins maintained normal levels of thymine and other nucleotides without creating the imbalances seen with folic acid alone. This suggests that the combination of vitamins and minerals in multivitamins provides more complete support for healthy cell development. The research also showed that the problems caused by folic acid alone could be partially fixed by adding back the missing thymine, confirming that this chemical imbalance was a real problem, not just an accidental finding.
Current medical guidelines recommend folic acid supplementation during pregnancy to prevent neural tube defects, and this recommendation is based on strong evidence that folic acid helps. This new research doesn’t contradict that finding—folic acid still helps prevent defects. However, it suggests that multivitamins might work even better in some cases. The finding that folic acid alone can cause excessive cell division and chemical imbalances is new and suggests the current understanding of how folic acid works may be incomplete. Previous research focused mainly on whether folic acid prevents defects, not on what happens at the cellular level when it’s used alone versus in combination with other nutrients.
This research has important limitations to consider. First, it was done in laboratory settings with mice and grown tissue, not in pregnant women. What happens in a lab may not exactly match what happens in a real pregnancy. Second, the mice used had genetic conditions that made them resistant to folic acid or harmed by it—this doesn’t represent most human pregnancies. Third, the human tissue was grown to mimic early development but isn’t identical to a real developing baby. Fourth, the study didn’t test multivitamins in actual human pregnancies, so we don’t know if these lab findings translate to real-world benefits. Finally, the study didn’t specify exactly which vitamins and minerals in the multivitamins were responsible for the benefits, so we can’t say which components matter most.
The Bottom Line
Based on this research, pregnant women or those planning pregnancy should discuss prenatal supplementation with their doctor. Current evidence still strongly supports taking folic acid, but this research suggests a complete prenatal multivitamin may offer additional benefits. If you’re currently taking folic acid alone, talk to your healthcare provider about whether switching to a prenatal multivitamin makes sense for you. Don’t stop taking folic acid without medical guidance, as it remains an important nutrient for pregnancy. Confidence level: Moderate—this is promising early-stage research that needs human studies to confirm.
This research is most relevant to women who are pregnant or planning to become pregnant, especially those with a family history of neural tube defects or who have had a previous pregnancy affected by these defects. Healthcare providers recommending supplements to pregnant patients should be aware of these findings. People with genetic conditions affecting folic acid metabolism may find this particularly relevant. This research is less relevant to people who aren’t pregnant or planning pregnancy, though the findings about how nutrients affect cell health could have broader applications.
Neural tube defects develop very early in pregnancy, often before a woman knows she’s pregnant. This is why folic acid supplementation is recommended before conception and during the first trimester. If these findings are confirmed in human studies, benefits would likely need to start before pregnancy or very early in pregnancy to be effective. You wouldn’t expect to see obvious changes in your body from taking multivitamins—the benefits would be at the cellular level in developing tissue. Any changes in pregnancy outcomes would only be measurable after birth.
Want to Apply This Research?
- If using a pregnancy or health app, track daily prenatal supplement intake (type and dose) and note any side effects or concerns. Record the specific multivitamin brand and ingredients to share with your healthcare provider.
- Set a daily reminder to take your prenatal supplement at the same time each day (such as with breakfast). If switching from folic acid alone to a prenatal multivitamin, log the date of change and any observations about how you feel. Use the app to track any questions to ask your doctor at your next appointment.
- Use the app to maintain a record of your supplement regimen throughout pregnancy and share this with your healthcare provider at each visit. If you experience any concerns or side effects, log them with dates so you can discuss with your doctor. After pregnancy, continue tracking if breastfeeding, as some nutrients remain important during this period.
This research is preliminary laboratory and animal study findings that have not yet been tested in pregnant women. While promising, these results should not replace current medical guidelines or your doctor’s recommendations. Folic acid supplementation remains an evidence-based recommendation for pregnancy. Do not change your supplement regimen without consulting your healthcare provider. This information is for educational purposes only and is not medical advice. Always follow your doctor’s specific recommendations for your individual situation, especially if you have a personal or family history of neural tube defects or other pregnancy complications.