Folic Acid Supplements Before and During Pregnancy, Reduced Risk of Cleft Lips and Palates, Spina Bifida, Anencephaly

By Ina Woolcott

A study published in the British Medical Journal indicates that folic acid, a B vitamin that has been proven to decrease occurrences of natal deformities in children, is effective in reducing the risk of another widespread birth defect, cleft lips and palates.

Previously, researchers found that women who ingested folic acid as part of their diet before conception, and during the early stages of pregnancy, had a 15-50% reduced risk of neural tube defects (NTD) in their children.

NTDs occur when a foetus' spine fails to close properly during the early stages of pregnancy. The most frequently occurring form of NTD is spina bifida, which can cause limited to severe impairment of both motor and cognitive skills. The most severe form of NTD is anencephaly, the congenital absence of most of the brain and spinal cord, where neither the brain nor the skull form fully.

Due to folic acid reducing the number of cases of NTDs led both the Canadian and U.S. governments to mandate the fortification of all grain products in 1998.

The recent study, executed in Norway by the U.S. National Institutes of Health (NIH), the Norwegian University of Bergen, Haukeland University Hospital, the University of Oslo and Rishospitalet at Oslo, shows that the ingestion of folic acids by expectant mothers of 400 micrograms or more, prior to conception and during the early stages of pregnancy decrease the risk of their child having a cleft lip or palate by 40 percent.

Like NTDs, cleft lips and palates take place during the early stages of pregnancy - the first 10 weeks - when a foetus' lips or the hard palette of the mouth does not close properly, leaving a crevasse.

Mothers who had diets without folic acid supplements or multivitamins, but instead ate foods that are naturally rich in folates, such as fruits and vegetables, decreased the risk of cleft palate or lips by up to 25%.

"Given the current levels of folic acid supplementation in Norway, and the estimated reduction in risk with folic acid, we estimate that an additional 22% of isolated cases of cleft lip with or without cleft palate could be averted if all pregnant women took greater than or equal to 400 micrograms of folic acid a day," the lead author of the study stated, Allen Wilcox of the National Institute of Environmental Health Sciences.

There is no mandatory folic acid fortification in Norway at this time of writing.