Birth Outcomes and Neural Tube Defects in the United States before and after Folic Acid Fortification

Jessica C. Bishop, Florida State University
Ursula Keller, Florida State University

Research suggests that women of varying racial/ethnic and socio-demographic backgrounds are differentially at risk for neural tube defect (NTD) births. Specifically, African-American women appear to have the lowest risk of births complicated by NTD, while Non-Hispanic White and Hispanic women have the highest risk of such birth outcomes. Young maternal age and low levels of maternal education are also associated with increased risk of NTD. It remains unclear, however, if the background factors that are linked to births with NTD before the folic acid enrichment (mandated in 1998 by the FDA) are those factors that are associated with NTD after folic acid enrichment. Using vital registration data from the 1990 and 2002 U.S. birth cohorts, we examine the racial/ethnic and socio-demographic characteristics of women giving birth in both 1990 and 2002 to assess the impact of folic acid fortification on the occurrence of neural tube defects.