Use of folic acid for the prevention of spina bifida and other neural tube defects - 1983-1991

Article Abstract:

Neural tube defects affect about 4,000 newborn infants every year in the United States, and are a frequent cause of serious disability and death. One of the most common types of neural tube defect occurs when the spine of the fetus fails to close (spina bifida). The resulting damage to the spinal cord causes varying degrees of paralysis, and loss of bowel and bladder control. In some cases, complications lead to mental impairment. Women who have had one child with a neural tube defect are at high risk for having another infant with the same defect. Recently the British Medical Research Council (MRC) Vitamin Study Group reported the results of a trial undertaken to prevent such defects using daily oral supplements of folic acid before pregnancy and during the early months, when the fetus' spine is forming. Neural tube defects occurred in six (1 percent) of 593 high risk pregnancies of women taking folic acid, and in 21 (3.5 percent) of the 602 women who did not take the supplements. Daily doses of 4 milligrams (mg) of folic acid before and during early pregnancy thus reduced neural tube defects by 71 percent. Multivitamins without folic acid did make a significant difference in the number of neural tube defects. No adverse effects were detected, and the study was terminated early so that all women at risk could take the supplement. The use of 4 mg of folic acid is recommended for all women who have previously had a child with a neural tube defect. This is an interim recommendation, because another study has found a preventive effect at only 0.36 mg per day. The text of the recommendation is included. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Abnormalities, Neural tube

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Recommendations for use of folic acid to reduce number of spina bifida cases and other neural tube defects

Article Abstract:

The US Public Health Service recommends that women take 0.4 milligrams of the B vitamin folic acid very day before conception and during early pregnancy to prevent neural tube defects (NTD). NTDs are abnormalities such as anencephaly and spina bifida that are caused by incomplete closure of the spinal cord. Approximately 2,500 newborns are born with NTDs in the US each year. Women who have had a baby with an NTD have a higher risk of having another baby with an NTD than other women. A research study found that women who had had an infant with NTD could reduce their risk of having another one by 70% by taking a high-dose supplement of folic acid. Other research studies found that women who had never had an infant with NTD could reduce their risk of having one by taking a low-dose folic acid supplement. The Public Health Service has started a campaign to educate women of childbearing age regarding folic acid supplementation.

Usage

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Spina bifida and anencephaly before and after folic acid mandate-United States, 1995-1996 and 1999-2000

Article Abstract:

Neural tube defects (NTDs) are birth defects of the spine, (e.g., spina bifida) and the brain (e.g., anencephaly) that occur early during pregnancy much before the woman actually knows she is pregnant. It was fortunately found that nearly 70% of these defects can be prevented if a woman consumes enough folic acid daily throughout the first trimester of her pregnancy, but more research is required to identify if NTD-affected pregnancies are due insufficient folic acid or other reasons.

United States, Causes of, Influence, Folic acid deficiency

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