PHS recommends folic acid for women of childbearing age - Public Health Service

All women of childbearing age should consume 0.4 milligrams daily of folic acid, a B vitamin, to reduce the risk of neural tube birth defects in their children, the U.S. Public Health Service recently announced.

The recommendation is published in a supplement of the Sept. 14, 1992, Morbidit?; and Mortality Weekly Report of the national Centers for Disease Control, a PHS agency.

According to the announcement, the 0.4 level should be consumed daily by women, whether pregnant or not, because the defects occur the first month after conception, generally before a woman is aware she is pregnant. Thus, all women from puberty through menopause who might become pregnant are urged to consume daily 0.4 milligrams (sometimes listed as 400 micrograms). They should not take more than 1 milligram a day, however, because overdosing can mask the symptoms of pernicious anemia, a vitamin [B.sub.12] deficiency. If this deficiency is not diagnosed and treated, neurological damage associated with it may progress.

Good sources of folic acid include leafy dark-green vegetables, citrus fruits and juices, yeast breads, and beans, as well as fortified breakfast cereals. Folic acid supplements and daily multi-vitamin preparations containing 0.4 milligrams of folic acid also are widely available.

The recommendation is based on an analysis of studies in the United Kingdom, Hungary, Cuba, and Western Australia, as well as three in the United States-one in Atlanta, one in California and Illinois, and one in New England. It is consistent with the current U.S. allowance on food and vitamin labels, but is about twice the Recommended Dietary Allowance set in 1989 by the National Academy of Sciences for the general population.

HHS Assistant Secretary for Health James Mason, M.D., said that FDA, CDC, the National Institutes of Health, and other agencies of the Public Health Service, which he heads, will work together to find the best way to implement this important public health recommendation.

About 2,500 infants with neural tube defects are born in the United States each year. Spina bifida and anencephaly account for 90 percent of neural tube defects. In anencephaly, most or all of the brain is absent, and such infants die before or shortly after birth. In spina bifida, the spinal cord is exposed. Most infants born with spina bifida grow to adulthood with varying degrees of disability despite surgical and other treatments.