USPSTF reaffirms benefit of folic acid supplementation
In an update of its 2009 statement on folic acid supplementation in women of childbearing age, the US Preventive Services Task Force (USPSTF) has reaffirmed the value of the vitamin for prevention of neural tube defects (NTDs). Published in JAMA, the new report recommends that all women who are planning or capable of pregnancy take a daily supplement containing 0.4 mg to 0.8 mg of folic acid.
This review of the evidence included 1 randomized clinical trial, 2 cohort studies, 8 case-control studies, and 2 publications from the 2009 analysis and looked at evidence of the effectiveness of folic acid supplementation in at least 41,802 participants. Results were not pooled because of study heterogeneity and differences in food fortification over time. The review did not include evidence on folic acid supplementation in women with a history of pregnancy affected by NTDs or other high-risk factors or on fortification, counseling to increase dietary intake of folic acid or naturally occurring food folate, or screening for NTDs.
As was the case 8 years ago, the USPSTF found that the net benefit of folic acid supplementation is substantial and that the harms to the mother or infant of taking the vitamin at typical doses are no greater than small. No substantial new evidence was identified of either the benefits or harms of folic acid that would have led to a change in the group’s previous recommendation.