Neural tube defects and periconceptional folic acid in England and Wales: retrospective study Commentary: Food should be fortified with folic acid

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# Neural tube defects and periconceptional folic acid in England and Wales: retrospective study {#article-title-2} The risks of a first occurrence and a recurrence of neural tube defects have been shown to be reduced by periconceptional folic acid supplementation—that is by taking folic acid from 3 months before conception to 3 months after conception.1 2 The Expert Advisory Group in the United Kingdom recommended in 1992 that women who were trying to conceive should take 0.4 mg folic acid per day.3 We assessed whether there had been any change in the incidence of neural tube defects since this recommendation was made. The number of live births, stillbirths, and pregnancies terminated because the fetus had a neural tube defect (spina bifida, anencephaly, or encephalocele) as well as the total number of live births, stillbirths, and abortions among residents of England and Wales from 1972 to 1996 were obtained from the Office for National Statistics. The true incidence of these abnormalities was defined as the number of affected infants (born alive or dead) plus the number of pregnancies terminated after prenatal diagnosis of a neural tube defect and expressed as a proportion of 100 000 live births, stillbirths, and terminations for neural tube defects. The number of prescriptions dispensed and the number of preparations sold over the counter containing 400 μg to 500 μg folic acid were provided by the Department of Health and Self Medication UK, a department of Intercontinental Medications Statistics-Health, (Pinner, Middlesex), respectively. The total number of prescriptions dispensed was available but data for over the counter sales do not include information from Boots pharmaceutical …