Birth Defects COUNT is CDC’s global initiative to reduce death and lifelong disability resulting from neural tube defects.
There are more than 300,000 neural tube defects worldwide each year. Expanding the reach of global folic acid fortification in low- and middle-resource countries can prevent 150,000–210,000 neural tube defects each year (1).
Watch the video, The Story of Folic Acid Fortification, to learn how folic acid fortification helps prevent birth defects.
Neural Tube Defects
Neural tube defects are serious birth defects of the brain and spine. The two most common neural tube defects are spina bifida and anencephaly. They happen very early in pregnancy when the neural tube, which becomes the brain and the spine, does not close properly.
Folic acid is a B vitamin. If a woman has enough folic acid in her body before and during early pregnancy, it can help prevent neural tube defects. Women need 400 micrograms (mcg) of folic acid every day.
Women can get folic acid by:
- Taking a vitamin with 400 mcg of folic acid in it
- Eating food that is fortified with folic acid (such as some breakfast cereals and other grain products)
- Eating food that has folate in it
In the United States
In 1992, the U.S. Public Health Service recommended that all women of childbearing age capable of becoming pregnant consume 400 mcg of folic acid daily to prevent neural tube defects.
By 1998 in the United States, folic acid was added to all cereal grain products labeled as enriched, like breakfast cereals and corn grits. This process is called folic acid fortification. In the United States, fortification led to a 36% decrease in the rate of neural tube defects (1, 2, 3). Fortifying foods with folic acid is an effective way to increase a woman’s intake of folic acid without changing her dietary habits.
Worldwide, most neural tube defects are not being prevented (4). Expanding the reach of global folic acid fortification in low- and middle-resource countries can lead to the prevention of 150,000–210,000 neural tube defects each year (1). Countries such as Chile, South Africa, Canada and Costa Rica have seen a decrease in neural tube defects as a result of fortification. These successes can serve as examples or models to other countries considering fortification with folic acid.
- Centers for Disease Control and Prevention. CDC grand rounds: additional opportunities to prevent neural tube defects with folic acid fortification. MMWR - Morbidity & Mortality Weekly Report. 2010;59(31):980-4.
- Czeizel AE, Dudas I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med. 1992 Dec 24;327(26):1832-5.
- Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group. Lancet. 1991 Jul 20;338(8760):131-7.
- Oakley GP, Jr. The scientific basis for eliminating folic acid-preventable spina bifida: a modern miracle from epidemiology. Ann Epidemiol. 2009;19(4):226-30.