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Folic acid (also known as folate or vitamin B9) has been shown to reduce the risk that a fetus will develop a neural tube defect.1 About 50% to 70% of all neural tube defects can be prevented by taking 400 mcg of folic acid daily both before and during pregnancy.2
Since 1992, all women of childbearing age have been advised to consume 400 mcg of folic acid daily to reduce the risk of a pregnancy affected by a neural tube defect. The best way for women to get enough folic acid is through vitamin supplements and also by eating foods to which folic acid has been added (most cereals, breads, pasta, and other grain-based foods). Although a related form of the supplement (called folate) is present in orange juice and leafy, green vegetables (such as kale and spinach), folate is not absorbed as well as folic acid.3
The advisory about folic acid includes all women—not just those who are now pregnant—because neural tube defects occur so early during the pregnancy, often before a woman even knows she is pregnant. The advisory also includes women who are not even planning on pregnancy, because half of all pregnancies are not planned. All pregnant women and women who may become pregnant should take 400 mcg of folic acid daily, preferably in the form of a supplement.
In 1996, the U.S. Food and Drug Administration mandated that folic acid be added to breads, cereals, and other grain products.1 Since that mandate was issued, the number of infants born with spina bifida has dropped by 31%,4and the number of infants born with anencephaly has dropped by about 16%.1 One study showed that each year, about 1,000 fewer infants are born with a neural tube defect as a result of enriching foods with folic acid in the United States.3
Women who have already had a pregnancy affected by a neural tube defect or who have spina bifida themselves should take 4 mg (10 times the 400 mcg usually recommended) of folic acid daily at least 3 months prior to becoming pregnant and during pregnancy.
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