USPSTF recommends daily folic acid supplement intake before pregnancy
Click Here to Manage Email Alerts
The U.S. Preventive Services Task Force has released a draft recommendation advocating for individuals who are planning to or could become pregnant to take a daily folic acid supplementation of 0.4 to 0.8 mg to prevent neural tube defects.
“Neural tube defects can cause serious complications for babies including disability and death,” ask Force Member Katrina Donahue, MD, MPH, a professor in the department of medicine at the University of North Carolina, said in a press release. “Fortunately, taking folic acid before and during early pregnancy can help prevent neural tube defects.”
The guidance, an A grade, is consistent with the USPSTF’s final recommendation on the topic from 2017. According to the recommendation statement, the ruling does not apply to persons who previously had a pregnancy affected by neural tube defects or those who are at very high risk due to other factors.
The task force noted that neural tube defects are often caused by low folate levels within the body, and that while all pregnancies are at risk for the condition, there are several factors that can increase risk, including:
- a family history of neural tube defects;
- difficulty taking in nutrients because of weight loss surgery;
- having diabetes or obesity; and
- taking certain anti-seizure medications.
Hispanic individuals also have an increased risk for neural tube defects, although the reason for the association is undetermined, according to the task force.
The reaffirmation was based on a review of 12 observational studies. Task force members found no significant harms from folic acid supplementation, specifically those related to multiple gestation, autism and maternal cancer.
Folic acid was concluded to have a high certainty of substantial net benefit for the recommendation’s target population. However, the USPSTF highlighted related areas that still need research, including the treatment’s effectiveness among Hispanic individuals and “factors that contribute to variations in supplementation.”
“Because many people don’t get enough folic acid in their diets, it’s important that anyone who is planning to or could become pregnant take a daily supplement containing folic acid,” USPSTF Member Wanda Nicholson, MD, MPH, MBA, an adjunct professor in the department of obstetrics and gynecology at the University of North Carolina, said in the release. “The best time to start taking folic acid is at least 1 month before pregnancy and continuing through the first trimester.”
References:
- Folic acid supplementation to prevent neural tube defects: A limited systematic review update for the U.S. Preventive Services Task Force. https://www.uspreventiveservicestaskforce.org/uspstf/document/draft-evidence-review/folic-acid-supplementation-prevent-neural-tube-defects. Published Feb. 21, 2023. Accessed Feb. 21, 2023.
- Folic acid supplementation to prevent neural tube defects: U.S. Preventive Services Task Force draft reaffirmation recommendation statement. https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/folic-acid-supplementation-prevent-neural-tube-defects. Published Feb. 21, 2023. Accessed Feb. 21, 2023.
- Task Force issues draft recommendation statement on folic acid supplementation to prevent neural tube defects. https://www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/folic-acid-suppl-draft-rec-bulletin.pdf. Published Feb. 21, 2023. Accessed Feb. 21, 2023.