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December 2015

The Folic Acid Rescue Strategy: High-Dose Folic Acid Supplementation in Early Pregnancy

Author Affiliations
  • 1Department of Management, Public Health, and Health Management, Bar Ilan University, Ramat Gan, Israel
  • 2Motherisk Program, Division of Clinical Pharmacology and Toxicology, Sick Kids Hospital, University of Toronto, Toronto, Ontario, Canada

Copyright 2015 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Pediatr. 2015;169(12):1083-1084. doi:10.1001/jamapediatrics.2015.2235

Neural tube defects (NTDs) are serious birth defects with more than 300 000 deliveries annually worldwide, causing increased mortality, morbidity, disabilities, and economic burden. About 50% to 72% of NTDs are preventable by adequate folic acid supply in the critical period of organogenesis.1,2 This potential is vastly underused despite extensive public health efforts. The policy of folic acid supplementation is failing and has led to health inequalities.3 We analyze the current state of preconceptional folic acid use and propose the Folic Acid Rescue Strategy to increase the potential of folic acid supplementation in NTD prevention.