*This is an archive page. The links are no longer being updated.
1992.09.14 :  Folic Acid and Pregnancy Data

Contact: Bill Grigg 202/690-6867 - home 301/652-1864
(CDC) 404/639-3286
September 14, 1992

       The U.S. Public Health Service today recommended that all
women of child-bearing age consume 0.4 milligrams daily of folic
acid, a B vitamin, to reduce the risk of neural tube birth
defects.
       The recommended level is published in a supplement of the
Centers for Disease Control's Morbidity and Mortality Weekly
Report.     Good sources of folic acid in the diet include leafy
dark green vegetables, citrus fruits and juices, yeast, bread and
beans, as well as fortified breakfast cereals.  Folic acid
supplements and daily multi-vitamin preparations containing 0.4
mg folic acid are also widely available. 
       HHS Secretary Louis W. Sullivan, M.D., said, "Available
evidence indicates that, when consumed in adequate amounts
beginning several weeks before conception, folic acid will reduce
the risk of having a child with one of the serious neural tube
birth defects.  There are currently nearly 2,500 infants born
each year with spina bifida or anencephaly -- which disable and
kill."
       The recommendation is consistent with the U.S. Recommended
Daily Allowance -- the USRDA currently used on food and vitamin
labels.  However, it is about twice the Recommended Dietary
Allowances set by the National Academy of Sciences for the
general population.  According to today's statement, to be
effective, the 0.4 level should be consumed before pregnancy is
known.  To 
                                 
                             - More -
                               - 2 -

accomplish this, all female adolescents and adults who might
potentially become pregnant are urged to consume 0.4 milligrams
(sometimes listed as 400 micrograms) daily -- but to resist
overdosing, which can mask a vitamin B-12 deficiency such as
pernicious anemia. 
       Spina bifida is a condition in which the spinal cord is
exposed.  In anencephaly, most or all of the brain is absent. 
Though they may require a series of operations and other
treatments, a majority of babies born with spina bifida grow to
adulthood with varying degrees of disability.  Infants born with
anencephaly die shortly after birth.
       James Mason, M.D., HHS assistant secretary for health and
head of the U.S. Public Health Service, said, "It seems possible
that we can reduce the number of serious neural tube defects
through a good diet and/or supplements."
       Mason said the Public Health Service agencies, including
CDC, the Food and Drug Administration and the National Institutes
of Health, will work together to find the best ways to implement
this important public health recommendation.
       Speaking today in Atlanta at a conference on state birth
defects surveillance programs, CDC Director William L. Roper,
M.D., said, "We in the Public Health Service are making this
recommendation based on available scientific evidence and studies
that show that 0.4 mg of folic acid per day may reduce a woman's
risk of having a baby with spina bifida or other neural tube
defect."  The recommendation is based on an analysis of studies
of 

                             - More -
                               - 3 -

various levels of folic acid conducted in the United Kingdom,
Hungary, Cuba and Western Australia as well as three in the
United States (one in Atlanta, Ga., a second in California and
Illinois, and the third in New England).
       As formally published today the recommendation states:
          In order to reduce the frequency of NTDs and
          their resulting disability, the United States
          Public Health Service recommends that:
          All women of childbearing age in the United
          States who are capable of becoming pregnant
          should consume 0.4 mg of folic acid per day
          for the purpose of reducing their risk of
          having a pregnancy affected with spina bifida
          or other NTD.  Because the effects of high
          intakes are not well known but do include
          complicating the diagnosis of vitamin B12
          deficiency, care should be taken to keep
          total folate consumption under 1 mg per day,
          except under the supervision of a physician. 
          Women who have had a prior NTD-affected
          pregnancy are at high risk of having a
          subsequent affected pregnancy.  When these
          women are planning to become pregnant, they
          should consult their physicians for advice.
       FDA Commissioner David A. Kessler, M.D., said FDA supports
the recommendation and is committed to determining the safest and
most effective approach to delivering optimal folic acid levels
to women of child-bearing age.  "It's important that folic acid
consumption reach but not greatly exceed effective levels,
because high intakes may result in serious side effects," he
said.
     Folic acid is an essential nutrient used by the body to
manufacture DNA  -- a building block required for human cell
growth and optimal organ and tissue development.


                             - More -
                               - 4 -

       To reduce the risk of neural tube defects, adequate folic
acid consumption must begin before pregnancy because the defects
occur within the first month after conception -- generally before
a woman is aware she is pregnant.  Women should consume folic
acid daily for a month or more before conception and through the
first trimester of pregnancy -- but to ensure this, the PHS
recommendation is made for women of childbearing age, from
puberty through menopause.

                               ####