Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Vitamin B9, specifically in the bioactive form of 5-methyltetrahydrofolate (5-MTHF), is supported by scientific evidence for its role in pregnancy, particularly in reducing the risk of neural tube defects (NTDs). While its primary use is not explicitly for miscarriage prevention, folate deficiency has been associated with increased risk of early pregnancy loss. The mechanism is thought to involve folate’s critical function in DNA synthesis, repair, and methylation, all of which are essential for proper embryonic development and placental function. Epidemiological studies have observed that women with low folate status or elevated homocysteine (which can result from inadequate folate) may have a higher risk of miscarriage. Supplementation with folic acid or 5-MTHF is thus commonly recommended before and during pregnancy to ensure adequate maternal folate status.

However, randomized controlled trials specifically targeting miscarriage prevention (as opposed to NTD prevention) have yielded mixed results, and the evidence is not as robust as for NTDs. Still, given the safety profile and the broader benefits for fetal development, professional guidelines, such as those from the CDC and WHO, recommend periconceptional folate supplementation. 5-MTHF may be preferable for individuals with MTHFR polymorphisms, who may have impaired folic acid metabolism. In summary, while the evidence for direct miscarriage prevention is moderate, there is a plausible biological rationale and some supportive data.

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