Impact of Folic Acid Fortification of the US Food Supply on the Occurrence of Neural Tube Defects

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Abstract
Spina bifida and anencephaly, the most common neural tube defects (NTDs), together affect approximately 4000 pregnancies resulting in 2500 to 3000 US births annually.1,2 In randomized controlled trials, folic acid supplementation before conception and during the first trimester has been shown to reduce the recurrence of NTDs by 72% (relative risk, 0.28; 95% CI, 0.12-0.71) in women with a previous NTD-affected pregnancy,3 and in another randomized study, supplementation reduced the occurrence of NTDs by 100% (95% CI, 0.0-0.63).4