The Public Health Service strongly recommends that women of childbearing age take steps to consume 0.4 milligrams of the folic acid vitamin per day in order to reduce their risk of having a pregnancy affected with spina bifida (or other neural tube disorders). This prevention strategy works best if the folic acid and the resultant folate level in the blood is sufficient during the early months of a pregnancy. 

In 1996, the federal Food and Drug Administration took the step of mandating that all flour and enriched cereal grain products manufactured in the U.S. be fortified with folic acid. This was required as a method for raising the levels of this protective vitamin within the general public. This order was to be implemented in all manufactured grain pro-ducts by January 1998.

The Centers for Disease Control and Prevention announced this fall a finding showing that the folate levels of American women of child-bearing age are on the rise. As reported in the October 27th issue of the MMWR, the CDC’s latest National Health and Nutrition Examination Survey found that the average level of folic acid found in the blood during 1999 almost tripled from levels measured in nutrition surveys conducted during the early 1990s.

The most common neural tube birth defect (NTD) is spina bifida. Another defect is annencephaly which affects the brain and most often results in a miscarriage or early death. Data on NTD occurrence derived from the birth certificates of babies born in 1999 (conceived in 1998, after fortification became mandatory) is scheduled to be released before the end of this year. These data will provide the necessary information to evaluate the preventive impact of the folic acid fortification within the United States.

(Folate Status in Women of Childbearing Age – United States, 1999; MMWR Weekly, October 27, 2000 / 49(42);962-5)