Folic Acid: Helping to Prevent Birth Defects

(L-r): Oakley, Berry, Mulinare, Larry Edmonds, and Erickson. Edmonds helped put together the Public Health Service recommendation on folic acid, and developed the National Birth Defects Prevention Network Surveillance System that monitored NTD rates before and after fortification.
Photo courtesy of Joe Mulinare

This year marks the 20th anniversary of the US Public Health Service recommendation that women of childbearing age should daily consume 400 micrograms (mcg) of folic acid to help prevent certain neural tube defects (NTDs), namely, spina bifida and anencephaly.

CDC played a leading role in the making of that important recommendation. Several CDC scientists were involved in the research that led up to the recommendation, or contributed to the subsequent work on folic acid that continues today. Key CDC scientists in this effort included Joseph Mulinare, Robert J. Berry, J. David Erickson, and Godfrey Oakley.

Dr. Erickson explains that “These defects that folic acid prevents are hard things to deal with. There have been a tremendous number of babies born without these problems since this work was completed and the public health programs were put in place. And it’s extremely satisfying for me to have been a part of that. CDC employees can be proud to be part of an institution that’s able to do this kind of work.”

Dr. Oakley emphasizes: “We’re in the midst of making spina bifida go away globally, so we can’t tell the end of the story yet. We had to have the science right, and it was impeccable; and then, we had to be persistent. For every roadblock, we had to find a solution around it.”

In September 1992, the US Public Health Service recommended that all women capable of becoming pregnant should daily consume 400 mcg of folic acid to reduce their risk for having a pregnancy affected by spina bifida and anencephaly.

This recommendation was preceded a year earlier by a CDC recommendation for women at high risk who had an earlier pregnancy affected by an NTD. The 1991 CDC recommendation stated that women at high risk should plan subsequent pregnancies and consume 4,000 mcg per day of folic acid from the time they begin trying to become pregnant through the first trimester of pregnancy to reduce their risk. Both recommendations were based on scientific evidence that folic acid consumption reduced the risk for having a pregnancy affected by an NTD.

For more detailed information on Folic Acid, visit the CDC Folic Acid page.