Vitamins, folic acid and neural tube defects: Comments on investigations in the United States

Joe Leigh Simpson, James L. Mills, George G. Rhoads, George C. Cunningham, Howard J. Hoffman, Mary R. Conley

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


No clear answer concerning whether multivitamin/folate supplementation prevents neural tube defects (NTDs) is provided by three studies in the United States. All these studies are occurrence in nature, no recurrence studies having been conducted. The Atlanta Birth Defects Study is subject to pronounced memory and recall biases, the length between event and interview being as long as 16 years. In a second study (Boston University), objections can be raised to certain aspects of the experimental design, and the claim that 22 per cent of women started vitamins sufficiently early after pregnancy diagnosis to influence NTD formation is suspicious. Our NICHD case control study of 541 women in California and Illinois revealed no evidence for multivitamins or folic acid preventing NTDs. U.S. public policy‐makers face difficulties in applying results of recurrence or occurrence studies in high‐risk areas to low‐risk areas in the U.S.

Original languageEnglish (US)
Pages (from-to)641-648
Number of pages8
JournalPrenatal Diagnosis
Issue number8
StatePublished - Aug 1991

All Science Journal Classification (ASJC) codes

  • Genetics(clinical)
  • Obstetrics and Gynecology


  • Folic acid
  • Multivitamins
  • Neural tube defects


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