Folic Acid in the Prevention of Birth Defects

Every year, approximately 300,000 children around the world are born with neural tube defects (NTD), a failure of closure of the neural tube either in the cranial region or along the spine that result in anencephaly and spina bifida respectively. Infants born with anencephaly usually die within a few days of birth, and those with spina bifida typically live with various life-long disabilities and often experience mobility limitations.

Twenty years of rigorous research shows that adequate consumption of folic acid before and during the first trimester of pregnancy can prevent up to 50% – 70% of NTDs. As a result, in 1996 the FDA mandated that all food products made from enriched cereal grain flours be fortified with folic acid. Although the number of NTDs in the United States have been reduced by more than 30% since this mandate, there are still populations in this country and worldwide that can benefit from these safe and effective fortification programs.

This session of Public Health Grand Rounds focused on current efforts to further decrease the prevalence of NTDs in the United States, as well as discussed much needed global strategies to reduce the burden of NTDs worldwide through mandatory fortification of staple foods with folic acid.