Folic acid supplementation for prevention of neural tube defects: a meta-analysis of randomized trials
De-Regil LMPeña-Rosas JPFernández-Gaxiola ACRayco-Solon P
High-confidence evidence from multiple solid studies
Summary
A Cochrane meta-analysis of folic acid supplementation for prevention of neural tube defects (NTDs) in women planning pregnancy or in early pregnancy. Folic acid supplementation was associated with a significant reduction in NTD risk (relative risk reduction approximately 72%). Folate is an essential cofactor for DNA synthesis and methylation reactions; supplementation from 4 weeks before conception through 12 weeks of gestation is particularly recommended.
Key findings
- 1
Folic acid supplementation reduced NTD risk by approximately 72% (relative risk 0.28)
- 2
Effects were maximized when supplementation began before conception and continued into early pregnancy
- 3
Folate is an indispensable cofactor in DNA synthesis and the one-carbon metabolic (methylation) cycle
- 4
Dietary intake alone is often insufficient, making supplementation broadly recommended
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PR
Reported ~72% lower relative risk of neural tube defects when supplemented before/early pregnancy
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Last checked: 2026-06-24