U.S. Preventive Services Task Force Finds Stronger Evidence for Folic Acid Use During Pregnancy

Experts call for folic acid use both during pregnancy and before, since half of pregnancies in the U.S. are unplanned.

The findings of a new study appear to contribute more evidence that taking folic acid before and during pregnancy can prevent birth defects, leading a task force to reaffirm recommendations that a daily supplement be taken by any person who could be pregnant, or is planning to become pregnant in the future.

In the latest issue of the Journal of the American Medical Association (JAMA), researchers report that folic acid supplementation reduces the risks of neural tube defects while not increasing the mother’s risk of cancer.

University of North Carolina at Chapel Hill researchers conducted a systematic review of published research focusing on folic acid supplementation for the U.S. Preventive Services Task Force (USPSTF). Researchers reviewed 12 observational studies focusing on the effects of folic acid supplementation on neural tube defects, covering data for more than 1.2 million participants.

The studies focused on a range of outcomes, including the impact of folic acid supplementation on autism spectrum disorder, maternal cancer risk, and neural tube defects.

Three of the studies focused on the effects of folic acid and neural tube defects. One cohort study reported that taking folic acid significantly reduced the risk of neural tube defects. No link between folic acid and maternal cancer risk or folic acid and ASD risk was found.

Task Force Upholds Folic Acid Recommendations

After reviewing the findings of this latest study, the USPSTF issued a statement reaffirming its previous recommendations for folic acid supplementation.

The task force recommends that any person who could be pregnant, or is planning to become pregnant in the future, should take a daily supplement of 0.4 to 0.8 mg of folic acid to prevent neural tube defects.

Due to modern diets, folic acid deficiency is fairly common. In addition, many medications can lead to impaired folate metabolism, which can also cause folate deficiency.

Neural Tube Birth Defect Risks

Neural tube defects are among the most common birth defects in the United States and occur when the neural tube, which forms the early brain and spine, does not close properly. Roughly 3,000 pregnancies result in neural tube defects every year.

These types of birth defects include spina bifida, a spinal cord defect, and anencephaly, a defect that leaves the infant without parts of the brain and skull. Spina bifida can cause mild to severe physical and intellectual disabilities. Infants born with anencephaly die shortly after birth.

Neural tube defects begin to form 26 to 28 days after conception, early in the pregnancy. Nearly half of all pregnancies in the U.S. are unplanned, which is why the USPSTF not only recommends taking folic acid for women while pregnant, but also before they become pregnant.