Healthy Babies Healthy Babies
Centers for Disease Control and Prevention


Neural Tube Defects:

Neural tube defects (NTDs) are serious birth defects of the brain (anencephaly) and spine (spina bifida) that occur in early pregnancy. These birth defects can cause babies to die within days of birth or live with serious, life-long disabilities. Every year, there are about 300,000 pregnancies affected by NTDs around the world including the U.S.

Folic acid is a B vitamin that the body needs to make new cells. Everyone needs folic acid. However, if a woman takes 400 micrograms (0.4 mg) of folic acid daily, before and during pregnancy, it can help prevent anencephaly and spina bifida.

What has been done?

Fortification of staple foods with folic acid is a feasible, economical, safe, and effective public health policy to prevent birth defects of the brain and spine.

In 1996, the Food and Drug Administration (FDA) established regulations that requiring that by 1998 all standardized enriched cereal grain products sold in the U. S. include 140 micrograms folic acid/100 grams and allowed for the addition of folic acid to breakfast cereals, corn grits, infant formulas, medical foods, and foods for special dietary use. The fortification mandate does not apply to corn masa flour, whole grain breads and corn meal products manufactured in other countries. Before fortification, about 4,130 babies had NTDs each year in the U. S., and nearly 1,200 died. After fortification, the yearly number of pregnancies affected by NTDs dropped to about 3,000, and the related deaths declined to 840. The issue continues: Approximately 75% of non-pregnant U.S. women of reproductive age did not consume the recommended daily intake of folic acid during 2003–2006. Hispanics have the highest rate among women who have a child affected by NTDs. What can be done? The U. S. Public Health Service and CDC recommend that all women of childbearing age consume 400 micrograms of folic acid daily to prevent two common and serious birth defects, spina bifida and anencephaly. All women who can become pregnant should consume folic acid daily because half of U.S. pregnancies are unplanned and because NTDs occur often before a woman knows she is pregnant. One way to lower the risk of having a pregnancy affected by an NTD among Hispanics could be by fortifying corn masa flour with folic acid. Fortification of corn masa flour products could increase folic acid intake by nearly 20% for Mexican-Americans, who are at a 30-40% higher risk for NTDs. What is CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD) doing Food additive petition

CDC’s National Center on Birth Defects and Developmental Disabilities is providing scientific assistance to some of its partners to develop a food additive petition to FDA to fortify corn masa flour, the flour used to make corn tortillas, with folic acid.


Birth defects can cause lifelong problems with health, growth, and learning. We want to find ways to prevent birth defects. To do that, we need to know what causes them. Research gives us important clues about things that might increase or decrease the risk of having a baby with a birth defect. Those clues provide information to help develop sound public health policies, materials and programs.