Folic acid supplements taken by mothers greatly reduces risk of cleft lips and palates in infants

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Previously, researchers had found that women who included folic acid in their diet prior to conception and during the early stages of pregnancy, had a 15 to 50 percent reduced risk of neural tube defects (NTD) in their children.

NTDs are caused when a fetus’ spine fails to close properly during the early stages of pregnancy. The most common form of NTD is spina bifida, which can cause limited to severe impairment of both cognitive and motor skills. The most severe form of NTD is anecephaly, where neither the brain nor the skull form fully.

The role of folic acid in the reduction of instances 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, has shown that the consumption by expectant mothers of 400 micrograms or more of folic acid 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 cleft palates occur during the early stages of pregnancy -- the first 10 weeks -- when a fetus’ lips or the hard palette of the mouth does not close properly, leaving a crevasse.

Mothers who consumed diets independent of 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 as much as 25 percent.

“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 percent 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,” said the lead author of the study, Allen Wilcox of the National Institute of Environmental Health Sciences.

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

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