The addition of folic acid to all enriched cereal grain products has reduced the prevalence of the birth defect spina bifida in the United States.
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According to The Journal of the American Medical Association, the birth defect was reduced 22.9 percent from 1995 to 1999; however, there have been no further decreases from 2003-2004.
This folic acid increase was mandated to prevent pregnancies affected by neural tube defects (NTDs) such as spina bifida.
The prevalence of NTD-affected pregnancies has remained higher among Hispanic women than among women in other racial/ethnic populations. Analysis of birth certificate data in the United States have shown that the number of cases of spina bifida were excluded because most conceptions with births during that period occurred before folic acid fortification was mandated in the United States.
Analysis has also shown significant decreases in prevalence among infants with non-Hispanic black mothers, but not among infants with non-Hispanic white mothers or Hispanic mothers.
The report shows two limitations: birth defects are underreported on birth certificates, even defects such as spina bifida that are obvious at birth. Also, birth certificates are complted for live births only, so pregnancies affected by spina bifida that ended in induced or spontaneous abortion were not recorded.
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