RCOG & FSRH on the fortification of flour with folic acid

RCOG & FSRH on the fortification of flour with folic acid

Public Health Minister Steve Brine will announce that the Government plans to consult on the mandatory fortification of flour with folic acid in a bid to tackle foetal abnormalities.

The consultation will launch in early 2019 to consider the evidence around folic acid fortification as well as the practicality and safety.

Evidence from the Scientific Advisory Committee of Nutrition (SACN) suggests that expectant mothers can take folic acid during pregnancy to significantly reduce the risk of foetal abnormalities including:

  • spina bifida – where the membranes around the spine do not close properly and in some cases affect walking or mobility
  • anencephaly – where the majority of the brain never develops
    Approximately 700 to 900 pregnancies are affected by neural tube defects each year in the UK.

Women who are trying to become pregnant are advised to take a daily supplement of 400 micrograms of folic acid before they conceive and during the first 12 weeks of pregnancy. However, around half of pregnancies in the UK are unplanned, so many women are missing out on these nutrients early in their pregnancy.

The consultation will also consider if there are any risks to other members of the general public. These include whether additional folic acid in the diet will mask the diagnosis of conditions such as pernicious anaemia, which is a deficiency in the production of red blood cell.

Steve Brine, Public Health Minister, said:

“All women should be able to access the nutrients they need for a healthy pregnancy and in turn, reduce the risk of devastating complications.

We have been listening closely to experts, health charities and medical professionals and we have agreed that now is the right time to explore whether fortification in flour is the right approach for the UK. My priority is to make sure that if introduced, we are certain it is safe and beneficial for all.”

Commenting in response, Dr Alison Wright, Consultant Obstetrician and Gynaecologist and Vice President for the Royal College of Obstetricians and Gynaecologists (RCOG), said:

“The RCOG has long supported calls to fortify flour with folic acid across the UK as a public health measure to prevent birth defects in babies. We will continue to work together with politicians and charities to achieve this.

“There are approximately 1,000 diagnoses of birth defects in the UK, such as anencephaly and spina bifida per year, 85% of which currently result in an abortion. The evidence is clear that fortification will prevent around half of these defects.

“Fortifying flour with folic acid is a simple, safe and evidence-based measure that will reach women who don’t receive enough folic acid through their diet, as well as those who may not have planned their pregnancy. This is a real opportunity to improve outcomes for families and society as a whole.”

The RCOG has also commented on the importance of early diagnosis to reduce placenta complications.

Dr Asha Kasliwal, President of the Faculty of Sexual and Reproductive Healthcare (FSRH), said:

“We are pleased that Public Health Minister Steve Brine has today announced that the Government will consult on the mandatory fortification of flour with folic acid.

“FSRH alongside other colleagues has long called on the Government to introduce this simple yet highly-effective measure to prevent neural tube defects in babies and improve the long-term health of the population.

“Currently, many women of childbearing age are not receiving enough folic acid from their diets, and we know that almost half of pregnancies are unplanned. Folic acid fortification will help to ensure that pregnant women will have higher chances of delivering a healthy baby.”

Also see: Natera’s new biomarker for adverse pregnancy outcomes