Folic Acid Fortification Effectively Reduces Neural Tube Defects

Since being instated in 1998, there has been a near 30% drop in NTD occurrences.

The CDC’s weekly report on morbidity and mortality focused on the results of a new study that showed a decline in the number of neural tube defects since the FDA enforced folic acid enrichment across all grain products.

Since the requirement was instated in 1998, the birth prevalence of neural tube defects (NTDs), of which anencephaly and spina bifida are most common, has decreased 35% in the US and approximately 1,300 babies are born without an NTD that may have been affected prior to the folic acid fortification. Since the initial decrease, birth defects have remained relatively stable.

Researchers examined data from 19 population-based birth defects surveillance programs that covered the years 1999-2011. The data included cases of spina bifida and anencephaly among deliveries across three ethnic groups: non-Hispanic whites, non-Hispanic blacks, and Hispanics, as well as all racial and ethnic groups combined. Programs were grouped by those that ascertained diagnosis during prenatal period and those that did not, and included live births, stillbirths, and elective terminations.

The results showed a decline in NTDs across all racial and ethnic groups during the fortification period, however Hispanic women remained at a higher risk of having a baby with an NTD compared to other racial and ethnic groups. Non-Hispanic blacks had the lowest prevalence. Overall, a 28% reduction in NTD prevalence was observed across all programs.

The CDC stresses that women who are capable of becoming pregnant get at least 400 mcg of folic acid per day. Intake is especially important at least one month before conception in order to help prevent NTDs.

The CDC recommends the following in order to get the recommended daily value of folic acid:

  • Take a vitamin with 400 mcg of folic acid daily
  • Eat a bowl of breakfast cereal that contains 100% of the daily value of folic acid
  • Eat a diet rich in fortified grains as well as beans, peas, and leafy greens, which have a high value of folate


  1. Williams J et al. MMWR Morb Mortal Wkly Rep. 2015;64(01);1-5.