Birth Defects

The neural tube is the part of the baby that forms the brain, spinal cord and spine within the first month of pregnancy. When the neural tube does not form correctly, a serious birth defect can develop called a neural tube defect (NTD). NTDs occur very early in pregnancy, even before most women know they are pregnant.

  • Babies with an NTD can have a range of physical and mental disabilities. Some NTD-affected pregnancies end in miscarriage or stillbirth.
  • Worldwide, approximately 300,000 babies are born each year with a NTD ( Zaganjor et al., 2016). In the US, approximately 3,000 babies are born each year with an NTD (CDC, 2015). One hundred (100) babies were born with an NTD in Florida in 2007 (Florida Department of Health).
  • NTDs impact many people. Families and friends of children with NTDs must cope with the physical, emotional, and financial effects of these serious birth defects.
  • Children born with NTDs usually need life-long medical treatment. The lifetime medical costs for one child with spina bifida was estimated to be $791,900 in 2016 (Grosse et al. 2016).
  • It is estimated that 1,300 US babies are born without NTDs every year because of mandatory addition of folic acid to cereal grains (CDC, 2015).

Folic Acid & Prevention

Folate is a B vitamin that is very important in the development of a baby.

It is recommended by the US Public Health Service and other organizations (U.S. Preventive Services Task Force, March of Dimes, American Academy of Pediatrics) that all women able to become pregnant get 400 micrograms of folic acid every day to reduce NTD risk. 

We don't completely understand how folic acid prevents neural tube defects (NTDs). Some studies suggest that taking folic acid makes up for a diet poor in folate. Other studies suggest that it counteracts a problem with the body's ability to use and process folate (i.e., folate metabolism).

Even though we don't know exactly how it works, there is strong scientific evidence that folic acid can help prevent many neural tube defects (NTDs). Emerging research shows that folic acid may help to reduce the risk of other birth defects of the heart, face (cleft lip, cleft palate), urinary tract and limbs.


  • Centers for Disease Control and Prevention (CDC). Updated estimates of neural tube defects prevented by mandatory folic acid fortification – United States, 1995-2011. MMWR Morb Mort Wkly Rep. 2015; 64(1): 1-5.
  • Florida Department of Health, Florida Birth Defects Registry, 1998-2007. Accessed July 15, 2010.
  • Grosse SD, Berry RJ, Mick Tilford J, Kucik JE, Waitzman NJ. Retrospective assessment of cost savings from prevention: folic acid fortification on spina bifida in the U.S. Am J Prev Med. 2016; 50 (5 Suppl 1): S74-S80.
  • Zaganjor I, Sekkarie A, Tsang BL, et al. Describing the prevalence of neural tube defects worldwide: a systematic literature review. PLoS One. 2016; 11(4): e0151586.

Mom and son

Folate is needed for good health and may help reduce the risk of serious birth defects and some chronic diseases such as heart disease and certain cancers.