Patient description: 19 yo Hispanic female G1P1 at 32+ 6 weeks of gestational age presented to the OB clinic for routine follow up complaining of mild headache and leg swelling. Primary evaluation revealed BP of 146/99 and urine dipstick with 3+ proteins. Her BP and U/A were normal in previous visit. Repeat BP a few hours later is 150/100 mmHg. Laboratory studies showed a normal hematocrit, platelet count, and liver transaminase levels. She is complaining of fatigue but no fever or chills. She is also suffering of headaches with no vision changes. No shortness of breath, cough, chest pain, orthopnea and palpitations or skin rash were observed. Her physical exam was negative for abdominal pain, change in bowel habits, nausea, vomiting, dysuria, frequency, hematuria or frothy urine. Leg swelling was observed with no arthralgia or back pain. She has no specific past medical issues and only uses prenatal vitamins. Her family history is positive for DM type 2 and HTN. She is a social alcohol consumer with the negative history of smoking or drug use. She is only have one partner in past 2 years and didn't have any contraceptive methods since 2 years ago. Her BMI was 24 at the first

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  Pregnancy Complications Preeclampsia Capability of subject to comprehend and comply with study requirements 2. ≥ 18 years of age at time of consent 3. Subject is taking ≤1.1 mg of folic acid daily at the time of randomization 4. Live fetus (documented positive fetal heart prior to randomization) 5. Gestational age between 8+0 and 16+6 weeks of pregnancy (Gestational age (GA) of subjects will be calculated based on the first day of the last menstrual period (LMP) or ultrasound performed before 12+6. If early ultrasound and LMP dates differ by ≤ 7 days, base GA estimate on LMP date; if > 7 days, use early < 12+6 ultrasound) 6. Subject plans to give birth in a participating hospital site 7. Pregnant subjects must fulfill at least one of the following identified risk factors for pre-eclampsia (PE) Pre-existing hypertension (documented evidence of diastolic blood pressure ≥ 90 mmHg on two separate occasions or at least 4 hours apart prior to randomization, or use of antihypertensive medication during this pregnancy specifically for the treatment of hypertension prior to randomization) Pre-pregnancy diabetes (documented evidence of Type I or type II DM) Twin pregnancy Documented evidence of history of PE in a previous pregnancy BMI > 35 kg/m2 within 3 months prior to this pregnancy and up to randomization of this pregnancy (documented evidence of height and weight to calculate BMI is required)  Known history or presence of any clinically significant disease or condition which would be a contraindication to folic acid supplementation of up to 5 mg daily for the duration of pregnancy 2. Known major fetal anomaly or fetal demise 3. History of medical complications, including renal disease with altered renal function epilepsy cancer, or use of folic acid antagonists such as valproic acid 4. Individual who is currently enrolled or has participated in another clinical trial or who received an investigational drug within 3 months of the date of randomization (unless approved by the Trial Coordinating Centre) 5. Known presence of Alcohol abuse (≥ 2 drinks per day) or alcohol dependence Illicit drug/substance use and/or dependence 6. Known hypersensitivity to folic acid 7. Multiple Pregnancy (triplets or more) 8. Participation in this study in a previous pregnancy