- The US Preventive Services Task Force (USPSTF) recommends that all women of reproductive age take a daily folic acid supplement to reduce risks for neural tube defects.
Why this matters
- Neural tube defects are defects of the brain and spine affecting 6.5 cases per 10,000 live births.
- Most neural tube defects occur spontaneously, but risk factors include a personal or family history.
- One half of US pregnancies are unplanned; this recommendation should apply to all women of reproductive age and be part of preconception counseling.
- This recommendation reaffirms the 2009 recommendation statement.
- The USPSTF recommends “all women who are planning or capable of pregnancy take a daily supplement containing 0.4 to 0.8 mg of folic acid."
- The UTPSTF did not find clear evidence regarding varying dosage, timing, or duration of supplementation.
- The critical period is 1 mo prior to pregnancy and first 2-3 mo of pregnancy.
- Rates of neural tube defects have declined since the fortification of foods in 1998.
- Review of literature and expert recommendations by the USPSTF.
- Funding: The Agency for Healthcare Research and Quality.
- More research is needed on differences in ethnic/racial populations.