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Adequate maternal folic acid intake before conception and during the first trimester of pregnancy decreases incidence of congenital neural tube defects (JW Womens Health Sep 6 2007) and possibly cleft lip (JW Womens Health Mar 29 2007), but whether it might also lower rates of severe congenital heart defects is uncertain. Using birth and health databases in Quebec, investigators classified infants and stillbirths with severe congenital heart defects into two temporal cohorts: 1990 through 1998 (before mandatory fortification of grain products with folic acid in Canada) and 1999 through 2005.
Average birth prevalence of severe congenital heart defects was 1.64/1000 births during the 9 years before folic acid fortification. The rate fell by 6.…