Maternal & Newborn Atlas
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Folic acid supplementation before and in early pregnancy

Folic acid is a B vitamin. Taking it every day before and in early pregnancy lowers the chance that a baby is born with a neural tube defect, a serious birth defect of the brain or spine. US guidance advises everyone who is planning a pregnancy, or who could become pregnant, to take a daily supplement containing 0.4 to 0.8 mg (400 to 800 micrograms) of folic acid. MedlinePlus says that getting enough folic acid before and during pregnancy can prevent major birth defects of the baby’s brain or spine.

  • Intervention
  • In this atlas

Overview

Technical summary

USPSTF 2023 reaffirmation: daily 0.4 to 0.8 mg of folic acid, an A recommendation, for persons who are planning to or could become pregnant. The MRC Vitamin Study (1991) is the randomised trial behind the advice for women who had a previous affected pregnancy; its abstract does not give the dose. The USPSTF evidence update found no statistically significant harms for multiple gestation, autism or maternal cancer in the studies it reviewed. These sources do not cover higher-dose advice for people at higher risk.

About this intervention

Type
Medicine
Mechanism
Not reported

Claims and evidence

Context Persons planning to or able to become pregnant (USPSTF 2023 folic acid recommendation)

Recipient
Maternal
Population
Persons who are planning to or could become pregnant. The person takes the supplement; the benefit the USPSTF describes is in their offspring (neural tube defects).
Care setting
Not stated in the PubMed abstract
Geography
United States (statement of the US Preventive Services Task Force); the abstract names no country.
Life stage
Before conception and during pregnancy (persons planning to or who could become pregnant)
Gestational age
Not reported
Postnatal age
Not reported
Follow-up
Not applicable (recommendation context)
Eligibility: 1 inclusion criterion; 1 exclusion criterion
Included
  • Persons planning to or who could become pregnant
Excluded
  • Not stated in the PubMed abstract

  • Recommendation Guidance Certainty not assessed

    The US Preventive Services Task Force (USPSTF) recommends that all persons planning to or who could become pregnant take a daily supplement containing 0.4 to 0.8 mg (400 to 800 micrograms) of folic acid. It grades this an A recommendation. It says it has high certainty that folic acid supplementation has a substantial net benefit in preventing neural tube defects in their offspring. This is a 2023 reaffirmation of an earlier recommendation, made after an evidence update.

    Applies to Maternal
    • Persons who are planning to or could become pregnant. The person takes the supplement; the benefit the USPSTF describes is in their offspring (neural tube defects).
    • Not stated in the PubMed abstract
    • United States (statement of the US Preventive Services Task Force); the abstract names no country.
    • Before conception and during pregnancy (persons planning to or who could become pregnant)
    • Gestational age Not reported
    • Postnatal age Not reported
    Follow-up Not applicable (recommendation context)
    Certainty method
    Not assessed
    Limitations
    Only the PubMed abstract was read. It gives the dose, the grade and the task force wording of certainty, but not the evidence behind them. USPSTF certainty levels are the task force’s own wording and not a GRADE rating, so certainty is not assessed here. The abstract does not describe higher-dose advice for people at higher risk of a neural tube defect.
    Last checked
    2026-10-14
    Next evidence check due
    Not scheduled
    Sources and citations (5)

    1. Supports Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched. · Published 2023-08-01 · DOI: 10.1001/jama.2023.12876 · PMID: 37526713

      Locator
      Abstract, RECOMMENDATION, sentence 1
      How it applies
      PubMed abstract of the USPSTF 2023 reaffirmation statement.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      8aebb7955183bf45d033ae616f3a133c590a132e130ccfdecbc4810e40114a56
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    2. Supports Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched. · Published 2023-08-01 · DOI: 10.1001/jama.2023.12876 · PMID: 37526713

      Locator
      Abstract, RECOMMENDATION, sentence 2
      How it applies
      PubMed abstract of the USPSTF 2023 reaffirmation statement.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      8aebb7955183bf45d033ae616f3a133c590a132e130ccfdecbc4810e40114a56
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    3. Supports Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched. · Published 2023-08-01 · DOI: 10.1001/jama.2023.12876 · PMID: 37526713

      Locator
      Abstract, EVIDENCE ASSESSMENT, sentence 1
      How it applies
      PubMed abstract of the USPSTF 2023 reaffirmation statement.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      8aebb7955183bf45d033ae616f3a133c590a132e130ccfdecbc4810e40114a56
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    4. Background Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched. · Published 2023-08-01 · DOI: 10.1001/jama.2023.12876 · PMID: 37526713

      Locator
      Abstract, POPULATION, sentence 1
      How it applies
      Population and the reason for the statement.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      8aebb7955183bf45d033ae616f3a133c590a132e130ccfdecbc4810e40114a56
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    5. Background Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched. · Published 2023-08-01 · DOI: 10.1001/jama.2023.12876 · PMID: 37526713

      Locator
      Abstract, OBJECTIVE, sentence 1
      How it applies
      Population and the reason for the statement.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      8aebb7955183bf45d033ae616f3a133c590a132e130ccfdecbc4810e40114a56
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

Context Pregnancies of women with a previous neural tube defect pregnancy (MRC Vitamin Study)

Recipient
Fetal
Population
Fetuses and infants of women at high risk of a pregnancy with a neural tube defect because of a previous affected pregnancy. 1817 women were allocated at random; 1195 had a completed pregnancy in which the fetus or infant was known to have or not have a neural tube defect. The women took the supplement; the outcome is counted in the fetus or infant.
Care setting
33 centres in seven countries; the abstract does not name the countries or describe the settings.
Geography
Seven countries; the abstract does not name them.
Life stage
Supplementation around the time of conception; outcome at the end of the pregnancy
Gestational age
Not reported
Postnatal age
Not reported
Follow-up
Until a completed pregnancy in which the fetus or infant was known to have or not have a neural tube defect
Eligibility: 1 inclusion criterion; 1 exclusion criterion
Included
  • Women at high risk of a pregnancy with a neural tube defect because of a previous affected pregnancy
Excluded
  • Not stated in the PubMed abstract

  • Effect Interventional Certainty not assessed

    In the MRC Vitamin Study, a randomised double-blind trial with a factorial design at 33 centres in seven countries, women at high risk of a pregnancy with a neural tube defect (because of a previous affected pregnancy) were given folic acid, a mixture of seven other vitamins, both, or neither. Of 1195 completed pregnancies in which the fetus or infant was known to have or not have a neural tube defect, 27 had a neural tube defect: 6 in the folic acid groups and 21 in the two other groups. The authors report a 72% protective effect (relative risk 0.28, 95% confidence interval 0.12 to 0.71). The other vitamins showed no significant protective effect (relative risk 0.80, 95% CI 0.32 to 1.72). The abstract reports no demonstrable harm from folic acid, with limited ability to detect rare or slight adverse effects.

    Applies to Fetal
    • Fetuses and infants of women at high risk of a pregnancy with a neural tube defect because of a previous affected pregnancy. 1817 women were allocated at random; 1195 had a completed pregnancy in which the fetus or infant was known to have or not have a neural tube defect. The women took the supplement; the outcome is counted in the fetus or infant.
    • 33 centres in seven countries; the abstract does not name the countries or describe the settings.
    • Seven countries; the abstract does not name them.
    • Supplementation around the time of conception; outcome at the end of the pregnancy
    • Gestational age Not reported
    • Postnatal age Not reported
    Follow-up Until a completed pregnancy in which the fetus or infant was known to have or not have a neural tube defect
    Certainty method
    Not assessed
    Limitations
    Only the PubMed abstract was read. It does not give the folic acid dose, the numbers of women in each group, or the names of the countries. The counts pool the groups that received folic acid (alone or with other vitamins) against the groups that did not, so per-group denominators are not available and are not computed. The result is for women with a previous affected pregnancy; it does not by itself show the size of the benefit for women without one. 1817 women were allocated at random and 1195 are in the pregnancies the abstract counts.
    Last checked
    2026-10-14
    Next evidence check due
    Not scheduled
    Sources and citations (6)

    1. Supports Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group

      Publication · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched. · Published 1991-07-20 · PMID: 1677062

      Locator
      Abstract, sentence 3
      How it applies
      PubMed abstract of the MRC Vitamin Study report (Lancet 1991).
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      35b6b28be5184c6f9e902c7e02db97769b18f69f757aca52b0fa615917cd5af2
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    2. Supports Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group

      Publication · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched. · Published 1991-07-20 · PMID: 1677062

      Locator
      Abstract, sentence 4
      How it applies
      PubMed abstract of the MRC Vitamin Study report (Lancet 1991).
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      35b6b28be5184c6f9e902c7e02db97769b18f69f757aca52b0fa615917cd5af2
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    3. Supports Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group

      Publication · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched. · Published 1991-07-20 · PMID: 1677062

      Locator
      Abstract, sentence 5
      How it applies
      PubMed abstract of the MRC Vitamin Study report (Lancet 1991).
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      35b6b28be5184c6f9e902c7e02db97769b18f69f757aca52b0fa615917cd5af2
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    4. Background Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group

      Publication · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched. · Published 1991-07-20 · PMID: 1677062

      Locator
      Abstract, sentence 1
      How it applies
      Design, population and the authors’ conclusion.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      35b6b28be5184c6f9e902c7e02db97769b18f69f757aca52b0fa615917cd5af2
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    5. Background Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group

      Publication · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched. · Published 1991-07-20 · PMID: 1677062

      Locator
      Abstract, sentence 2
      How it applies
      Design, population and the authors’ conclusion.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      35b6b28be5184c6f9e902c7e02db97769b18f69f757aca52b0fa615917cd5af2
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    6. Background Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group

      Publication · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched. · Published 1991-07-20 · PMID: 1677062

      Locator
      Abstract, sentence 6
      How it applies
      Design, population and the authors’ conclusion.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      35b6b28be5184c6f9e902c7e02db97769b18f69f757aca52b0fa615917cd5af2
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

Context Pregnant persons and offspring in the studies of the USPSTF 2023 folic acid evidence update

Recipient
Mixed recipients
Population
Pregnant persons and their offspring in the 9 studies of the USPSTF 2023 evidence update that were eligible for harms: 1 randomized trial (n = 431) and 8 observational studies (7 with n = 761 125 and 1 with n = 429 004). The update looked for randomized and nonrandomized cohort studies in very highly developed countries. Harms were reported for multiple gestation, autism spectrum disorder and maternal cancer, so the context covers mothers and offspring and is not split by recipient.
Care setting
Randomized and nonrandomized cohort studies in very highly developed countries (the review inclusion rule); the abstract does not describe settings.
Geography
Very highly developed countries (review inclusion rule); countries are not named in the abstract.
Life stage
Pregnancy-related folic acid exposure and offspring outcomes
Gestational age
Not reported
Postnatal age
Not reported
Follow-up
Not stated in the PubMed abstract
Eligibility: 1 inclusion criterion; 1 exclusion criterion
Included
  • Studies eligible for harms of folic acid supplementation, searched July 1, 2015 through July 2, 2021, with surveillance through February 10, 2023
Excluded
  • Not stated in the PubMed abstract

  • Safety Evidence synthesis Certainty not assessed

    The evidence update behind the USPSTF 2023 folic acid statement looked for harms of folic acid supplementation around pregnancy. Nine studies were eligible for harms: 1 randomized trial (n = 431) on variations in twin delivery, 7 observational studies (n = 761 125) on autism spectrum disorder and 1 observational study (n = 429 004) on maternal cancer. No study reported statistically significant harms (multiple gestation, autism and maternal cancer) associated with pregnancy-related folic acid exposure.

    Applies to Mixed recipients
    • Pregnant persons and their offspring in the 9 studies of the USPSTF 2023 evidence update that were eligible for harms: 1 randomized trial (n = 431) and 8 observational studies (7 with n = 761 125 and 1 with n = 429 004). The update looked for randomized and nonrandomized cohort studies in very highly developed countries. Harms were reported for multiple gestation, autism spectrum disorder and maternal cancer, so the context covers mothers and offspring and is not split by recipient.
    • Randomized and nonrandomized cohort studies in very highly developed countries (the review inclusion rule); the abstract does not describe settings.
    • Very highly developed countries (review inclusion rule); countries are not named in the abstract.
    • Pregnancy-related folic acid exposure and offspring outcomes
    • Gestational age Not reported
    • Postnatal age Not reported
    Follow-up Not stated in the PubMed abstract
    Certainty method
    Not assessed
    Limitations
    Finding no statistically significant harm is not proof that there is none. The abstract gives no effect sizes for the harms. The update searched July 1, 2015 through July 2, 2021 (with surveillance through February 10, 2023), reviewed English-language studies in very highly developed countries, and was a limited update that did not repeat the whole earlier review. Only the PubMed abstract was read.
    Last checked
    2026-10-14
    Next evidence check due
    Not scheduled
    Sources and citations (5)

    1. Supports Folic Acid Supplementation to Prevent Neural Tube Defects: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched. · Published 2023-08-01 · DOI: 10.1001/jama.2023.9864 · PMID: 37526714

      Locator
      Abstract, FINDINGS, sentence 3
      How it applies
      PubMed abstract of the USPSTF 2023 evidence update.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      03317be3c7f14cbae88b7c9a5a78b42426113dada5354e4189ed07c527673a57
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    2. Supports Folic Acid Supplementation to Prevent Neural Tube Defects: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched. · Published 2023-08-01 · DOI: 10.1001/jama.2023.9864 · PMID: 37526714

      Locator
      Abstract, FINDINGS, sentence 7
      How it applies
      PubMed abstract of the USPSTF 2023 evidence update.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      03317be3c7f14cbae88b7c9a5a78b42426113dada5354e4189ed07c527673a57
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    3. Supports Folic Acid Supplementation to Prevent Neural Tube Defects: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched. · Published 2023-08-01 · DOI: 10.1001/jama.2023.9864 · PMID: 37526714

      Locator
      Abstract, CONCLUSIONS AND RELEVANCE, sentence 1
      How it applies
      PubMed abstract of the USPSTF 2023 evidence update.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      03317be3c7f14cbae88b7c9a5a78b42426113dada5354e4189ed07c527673a57
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    4. Background Folic Acid Supplementation to Prevent Neural Tube Defects: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched. · Published 2023-08-01 · DOI: 10.1001/jama.2023.9864 · PMID: 37526714

      Locator
      Abstract, EVIDENCE REVIEW, sentence 1
      How it applies
      Search period and inclusion rules of the update.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      03317be3c7f14cbae88b7c9a5a78b42426113dada5354e4189ed07c527673a57
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    5. Background Folic Acid Supplementation to Prevent Neural Tube Defects: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched. · Published 2023-08-01 · DOI: 10.1001/jama.2023.9864 · PMID: 37526714

      Locator
      Abstract, EVIDENCE REVIEW, sentence 2
      How it applies
      Search period and inclusion rules of the update.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      03317be3c7f14cbae88b7c9a5a78b42426113dada5354e4189ed07c527673a57
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

Guidance

Recommended: Folic acid supplementation before and in early pregnancy

Applies to Maternal
  • Persons who are planning to or could become pregnant. The person takes the supplement; the benefit the USPSTF describes is in their offspring (neural tube defects).
  • Not stated in the PubMed abstract
  • United States (statement of the US Preventive Services Task Force); the abstract names no country.
  • Before conception and during pregnancy (persons planning to or who could become pregnant)
  • Gestational age Not reported
  • Postnatal age Not reported
Follow-up Not applicable (recommendation context)
Issued by
U.S. Preventive Services Task Force
Guideline
USPSTF 2023: folic acid supplementation to prevent neural tube defects (reaffirmation); Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication (USPSTF final recommendation statement page), edition Final recommendation statement page as fetched on 2026-10-14 (mx-uspstf-folic-acid-for-the-prevention-of-neural-tube-defects-preventive-medication.html). The date under the title is August 01, 2023.
Strength
A recommendation (USPSTF letter grades: A, B, C and D recommendations, and the I statement for when the evidence is insufficient to recommend for or against. The grade reflects the Task Force's certainty about net benefit. These are not GRADE strength labels.)
Effective
2023-08-01 (The date under the title of the USPSTF final recommendation statement page, August 01, 2023. The statement was also published in JAMA, which has its own issue date.)
Jurisdictions
United States; note: United States (the issuer is a United States task force).
Supersession
Not checked
Basis
The US Preventive Services Task Force (USPSTF) recommends that all persons planning to or who could become pregnant take a daily supplement containing 0.4 to 0.8 mg (400 to 800 micrograms) of folic acid. It grades this an A recommendation. It says it has high certainty that folic acid supplementation has a substantial net benefit in preventing neural tube defects in their offspring. This is a 2023 reaffirmation of an earlier recommendation, made after an evidence update.

Limitations. Only the PubMed abstract was read. It gives the dose, the grade and the task force wording of certainty, but not the evidence behind them. USPSTF certainty levels are the task force’s own wording and not a GRADE rating, so certainty is not assessed here. The abstract does not describe higher-dose advice for people at higher risk of a neural tube defect.

Clinical links

Each link reports what one cited claim says about one population. "Evaluated for" means studied, not shown to work. These links do not show that anything is effective or right for you.

Record details

Record id
maternal:folic-acid-supplementation
Content hash
353701bf3e1017d97b2a23b149428c541f975849842fe4c4cad3172a54f48b5d