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November 10, 1999
Contact: CDC, Division of Media Relations
(404) 6393286

Folic acid use in China reduces neural tube birth defects by 85 percent

Daily consumption of folic acid in vitamin pill form has clearly demonstrated a significant reduction in neural tube birth defects in a report of child-bearing women in China. The project, which encouraged women to take 400 micrograms of folic acid a day in vitamin pill form, showed that the risk of neural tube birth defects was reduced by as much as 85 percent. The evaluation was conducted by the Centers for Disease Control and Prevention (CDC) and Beijing Medical University, China, and was published in the November 11, 1999 issue of the New England Journal of Medicine.

The documented positive results of this intervention clearly show that folic acid consumption as a vitamin pill is one very effective way to give children the best chance to be healthy and reduce the risk of neural tube birth defects.

The project, conducted in China, was a collaborative effort between lead author R. J. Berry, M.D, M.P.H.T.M., and other researchers from CDC's National Center for Environmental Health and Dr. Zhu Li, M.D., M.P.H., with researchers from Beijing Medical University, China.

"A woman can greatly improve the health of her unborn child by reducing the risk of a neural tube birth defect by simply taking folic acid before she becomes pregnant, " said Dr. Berry. "The formation of the spine where this birth defect occurs is complete within the first 28 days of pregnancy - before many women know they are pregnant. After this time passes, it is too late to prevent the damage."

For this project, a public health intervention was conducted in two areas in China from 1993 to 1995. One area of the project was a province in the northern region where the rates of neural tube birth defects were very high, and the other area was two southern provinces where the rates were lower and more similar to those in the US. In these two areas, the women who participated were closely monitored for their folic acid consumption prior to conception. Among the babies of women who took their daily recommended amount of folic acid more than 80 percent of the time, in the Northern region the risk of having a neural tube birth defect was reduced by 85 percent and in the Southern region the risk was reduced by 41 percent.

In the United States, neural tube birth defects affect an estimated 4,000 pregnancies each year. The most common of these defects is spina bifida, the leading cause of childhood paralysis. Another is anencephaly, which affects the brain and results in miscarriage, stillbirth, or babies who live only a few days. Researchers know that folic acid consumption is an effective way to prevent many of these birth defects if it is consumed before pregnancy.

In an effort to improve every child's chances at starting life with good health, CDC and the National Council on Folic Acid, chaired by the March of Dimes, are conducting an ongoing education campaign about folic acid. The education campaign is targeted at two segments of the population, those who are planning to become pregnant and those who are not. For those who are planning to become pregnant, the "Before You Know It" education materials and public service announcement stress that folic acid must be taken before the planned conception because before they realize they are pregnant, the birth defect that might have been prevented will have already occurred.

The education materials and public service announcement for those women who are not planning to become pregnant stress that a high percentage of pregnancies are not planned.

Therefore, whether they are ready or not to plan a pregnancy, they should take 400 micrograms of folic acid every day just to prepare for the day when they are ready to have a child, or for an unexpected pregnancy.

For more information visit this CDC website: http://www.cdc.gov/nceh/cddh/folic/default.htm


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