In the current issue of JAMA, The US Preventive Services Task Force (USPSTF) has published an update to its 2009 recommendation statement on the use of folic acid supplementation to prevent neural tube defects.1 The updated statement, informed by a systematic review of relevant information,2 remains unchanged from the 2009 recommendation. Specifically, the USPSTF continues to recommend that all women planning or capable of pregnancy take a daily supplement containing 0.4 to 0.8 mg (400 to 800 μg) of folic acid to reduce their risk of having a pregnancy affected by a neural tube defect. This recommendation applies to all women who are capable of becoming pregnant with the exception of women who have a high risk of a neural tube defect–affected pregnancy because they have a history of an affected pregnancy or another strong risk factor (eg, use of certain antiseizure medications). These women may be advised to take higher doses of folic acid. Like the 2009 recommendation, the current recommendation received a USPSTF grade of A. This grade indicates that there is a high certainty that folic acid supplementation is an effective means of primary prevention for neural tube defects. In addition, the A grade indicates that clinicians should advise women who are capable of becoming pregnant about the benefits of taking a daily folic acid supplement.
Mitchell LE. Folic Acid for the Prevention of Neural Tube DefectsThe US Preventive Services Task Force Statement on Folic Acid Supplementation in the Era of Mandatory Folic Acid Fortification. JAMA Pediatr. Published online January 10, 2017. doi:10.1001/jamapediatrics.2016.4983