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November 10, 1999 Daily consumption of folic acid in vitamin pill form has clearly demonstrated a significant
reduction in neural tube birth defects in a report of child-bearing women in China. The
project, which encouraged women to take 400 micrograms of folic acid a day in vitamin pill
form, showed that the risk of neural tube birth defects was reduced by as much as 85 percent.
The evaluation was conducted by the Centers for Disease Control and Prevention (CDC) and
Beijing Medical University, China, and was published in the November 11, 1999 issue of the New
England Journal of Medicine.
The documented positive results of this intervention clearly show that folic acid
consumption as a vitamin pill is one very effective way to give children the best chance to be
healthy and reduce the risk of neural tube birth defects.
The project, conducted in China, was a collaborative effort between lead author R. J.
Berry, M.D, M.P.H.T.M., and other researchers from CDC's National Center for Environmental
Health and Dr. Zhu Li, M.D., M.P.H., with researchers from Beijing Medical University, China.
"A woman can greatly improve the health of her unborn child by reducing the risk of a
neural tube birth defect by simply taking folic acid before she becomes pregnant, " said
Dr. Berry. "The formation of the spine where this birth defect occurs is complete within
the first 28 days of pregnancy - before many women know they are pregnant. After this time
passes, it is too late to prevent the damage."
For this project, a public health intervention was conducted in two areas in China from
1993 to 1995. One area of the project was a province in the northern region where the rates of
neural tube birth defects were very high, and the other area was two southern provinces where
the rates were lower and more similar to those in the US. In these two areas, the women who
participated were closely monitored for their folic acid consumption prior to conception.
Among the babies of women who took their daily recommended amount of folic acid more than 80
percent of the time, in the Northern region the risk of having a neural tube birth defect was
reduced by 85 percent and in the Southern region the risk was reduced by 41 percent.
In the United States, neural tube birth defects affect an estimated 4,000 pregnancies each
year. The most common of these defects is spina bifida, the leading cause of childhood
paralysis. Another is anencephaly, which affects the brain and results in miscarriage,
stillbirth, or babies who live only a few days. Researchers know that folic acid consumption
is an effective way to prevent many of these birth defects if it is consumed before pregnancy.
In an effort to improve every child's chances at starting life with good health, CDC and
the National Council on Folic Acid, chaired by the March of Dimes, are conducting an ongoing
education campaign about folic acid. The education campaign is targeted at two segments of the
population, those who are planning to become pregnant and those who are not. For those who are
planning to become pregnant, the "Before You Know It" education materials and public
service announcement stress that folic acid must be taken before the planned conception
because before they realize they are pregnant, the birth defect that might have been prevented
will have already occurred.
The education materials and public service announcement for those women who are not
planning to become pregnant stress that a high percentage of pregnancies are not planned.
Therefore, whether they are ready or not to plan a pregnancy, they should take 400
micrograms of folic acid every day just to prepare for the day when they are ready to have a
child, or for an unexpected pregnancy.
For more information visit this CDC website: http://www.cdc.gov/nceh/cddh/folic/default.htm
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