Fewer Neural-Tube Defects in Canada After Folic Acid Fortification

Daily consumption of 400 μg of folic acid before conception reduces the risk for fetal neural-tube defects, but many women do not consume the recommended amount. To increase the average daily intake of folic acid in Canada, fortification of white flour, enriched pasta, and cornmeal with folic acid was mandated in 1998.

Investigators identified 2446 infants with neural-tube defects from nearly 2 million live births, stillbirths, and pregnancy terminations in seven Canadian provinces from 1993 to 2002. Spina bifida and anencephaly accounted for 53% and 34% of the defects, respectively. Sixty percent of affected pregnancies were terminated after prenatal diagnosis. After folic acid fortification, the overall prevalence of neural-tube defects de…