A marked drop in birth defects has occurred in the U.S. since the Food and Drug Administration mandated the addition of folate to grain products in 1998. But to achieve further gains, all women capable of becoming pregnant need to comply with dietary folate guidelines, according to findings released last week.
Folate use before and during pregnancy has been shown to protect against neural tube defects (NTDs), including two of the most serious types - spina bifida and anencephaly. Spina bifida occurs when the backbone and spinal cord develop abnormally, whereas anencephaly involves defective skull development with missing brain regions and is invariably fatal.
Previous reports have suggested that 50 to 70 percent of NTD cases can be prevented with adequate folate intake. However, in the present analysis, the folate fortification program is credited with reducing the annual number of NTD-affected pregnancies from about 4000 to about 3000 - a reduction of just 25%.
If all women of childbearing age were to consume 400 micrograms of folate per day as recommended by the US Public Health Service, at least 1000 additional NTD cases could be prevented, researchers from the Centers for Disease Control and Prevention note.
Taking a vitamin with folic acid or eating a breakfast cereal fortified with 400 micrograms of folic acid per serving every day are important components of birth defects prevention efforts for women of childbearing age, regardless of pregnancy intention, said the investigators.
Doctors can play an important role in improving compliance with dietary folate guidelines. In a recent study, 88 percent of reproductive age women surveyed said they would take a folate supplement if advised to do so by their doctor, but only 37% reported actually receiving this recommendation.
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