The Annals of Internal Medicine has published a clinical guideline produced by the United States Preventive Services Task Force (USPSTF) regarding the use of folic acid pre-conceptually and during pregnancy to prevent neural tube defects.
Evidence published since 1996 for folic acid supplementation in women of childbearing age was reviewed although information regarding food fortification, advice to increase dietary intake and neural tube defect screening were not reviewed.
The review does not apply to women who have had a previous pregnancy affected by neural tube defects or women taking certain anti-seizure medicines. Such patients are normally recommended to take higher doses.
According to this review, neural tube defects affect approximately 1 in every 1,000 pregnancies and most cases occur in the absence of any positive history. As such the guideline recommends that all women planning a pregnancy should take a daily supplement containing 400-800 micrograms of folic acid for at least a month before conception and for the first three months of pregnancy.
Action: Clinicians will already be aware of this advice however this guideline encourages broader use of supplements.
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