- The ARC - California Edition -

Prevention of Neural Tube Defects

New Evidence on Preventing Birth Defects With Folic Acid

In the November 10, 1999 issue of the New England Journal of Medicine, there is some very dramatic evidence that providing folic acid supplementation can be a powerful tool for reducing neural tube defects.

Researchers in China reported that after studying 250,000 females of pregnancy-age, they had found that women who regularly took folic acid supplements had 89 percent fewer babies with brain and spine defects.

The medical profession has been aware that if a woman system has a shortage of the B vitamin Folic Acid during her pregnancy, the result may be an infant with brain and spine defects.

For almost ten years, there has been strong evidence that if every woman regularly took a Folic Acid supplementation for at least a month before she got pregnant through her first trimester, she would reduce her risk of delivering a baby with any of the disabling neural tube defects.

The success of this China study is dramatic and striking. Previous studies in the US had reported about a 50% reduction in risk of neural tube defects. There is a major difference between the Chinese approach to supplementation and the American approach which is worth examining.

Each of the Chinese women involved in receiving the folic acid supplement was requested to start taking the a pill containing 400ug of folic acid alone daily from the time of her “premarital” examination (before marriage) until the end of her first trimester of pregnancy.

The approach in the US was originally based on media coverage to raise the general awareness of the need for increasing the level of folic acid, and to have the medical profession provide the request to a pregnant woman to take a multivitamin supplement, including 400ug of folic acid. This request often was occurring after the first trimester was essentially passed.

Recently, the Food and Drug Administration recommended that manufacturers add folic acid as a fortification within most grain products. Although this recommendation could have been a meaningful solution, the agency only approved an additive equivalent to 100ug of folic acid. This is only ¼ of the amount considered necessary by many scientists to be effective.

A defect in the neural tube system can begin in the first 28 days of pregnancy, before most women know they are pregnant and have the chance to take prenatal vitamins. As a result, doctors now recommend that women who could become pregnant should regularly take 400ug of folic acid each day so they will have plenty in their body if a child is conceived.