Folic Acid Fortification and Neural Tube Defects

Neural tube defects are a group of birth defects that result from improper development of the spine, spinal cord, or brain during pregnancy. Spina bifida, in which some of the spinal cord bulges out through an opening in the spine, is most common. Neural tube defects occur in children of all ethnic backgrounds and in all countries.

Research studies have shown that a woman who takes folic acid supplements prior to and during pregnancy reduces her risk of having a child born with a neural tube defect. The neural tube is fully developed between 22 and 28 days after conception (3-4 weeks), but many women are not even aware they are pregnant at that time.

Current Status

Approximately 40 countries have implemented programs to prevent folic acid-related birth defects. Some of these programs involve education of mothers-to-be about the importance of taking folic acid supplements prior to conception and during pregnancy. In some countries, such as the United States, Chile, Canada, and Israel, the food supply (usually flour) is fortified with folic acid as a way of bringing folic acid to women of childbearing age.

Background

Although it is known that folic acid supplementation has good benefits for mothers-to-be, there is debate about the necessity of putting folic acid in the food supply. There has been discussion about the long-term effects of food fortification, as well as what effects folic acid may have on the general population, who would also be consuming the fortified foods.