Folic acid use and neural tube defects: Data blog
Folic acid supplementation in those of reproductive age and its role in preventing neural tube defects (NTDs) in Canada.
- Last updated: 2026-06-09
Overview
Neural tube defects (NTDs) are a type of congenital anomaly, a condition present at birth, that affects the brain, spine or spinal cord. They are rare but have the highest fatality rate among congenital anomaliesFootnote 1. Folate is a B vitamin that is naturally found in certain foods. Folic acid is a form of folate added to fortified foods and supplements. Folate (folic acid) is important for the healthy growth of unborn babies. It helps reduce the risk of NTDs. Folic acid is the only form of folate that has been shown to reduce the risk of NTDs.
A daily multivitamin with 400 mcg (0.4 mg) of folic acid is recommended for anyone who could become pregnant.
To learn more on folic acid and NTDs, visit Folic acid, healthy pregnancy and neural tube defect prevention.
Prevalence of NTDs and folic acid use
Over the past 15 years, the trend of NTDs has remained stable. A total of 2,798 infants were diagnosed with an NTD (4.8 cases per 10,000 total births) between 2008 and 2023Footnote 1.
81% of womenFootnote * who gave birth in the last 5 years knew that taking folic acid before conception can lower the risk of NTDs in 2022Footnote 2. This is up from 71% in 2015 Footnote3.
67% of women who gave birth in the last 5 years reported taking folic acid in the 3 months before conception in 2022Footnote 2. This is up from 60% in 2015Footnote 3.
Age
The proportion of women of reproductive age who reported taking a vitamin supplement with folic acid varied by age groupFootnote 2:
- 7.9% of those aged 15 to 24 years
- 30.4% of those aged 25 to 34 years
- 22.0% of those aged 35 to 55 years
The rate of NTDs among infants born to women aged less than 25 years is approximately 1.5 times higher than the rate of NTDs among infants born to those aged 25 to 39 yearsFootnote 4.
Geographic location
The proportion of women of reproductive age who reported taking a vitamin supplement with folic acid was the lowest among those who live in Quebec (14.0%)Footnote 2. It was highest among those who live in the Prairies (26.5%)Footnote 2.
No differences were observed in folic acid supplementation among women who lived in rural areas compared to those living in urban areasFootnote 2.
Education and income
The proportion of women of reproductive age who reported taking a vitamin supplement with folic acid was significantly higher among women with a post-secondary certificate or university degree (24.7%)Footnote2. This is in comparison to those who had a high school education (19.7%)Footnote2.
Among women of reproductive age, folic acid use was similar across income groupsFootnote2.
Resources
- Public Health Agency of Canada: Folic acid, healthy pregnancy and neural tube defect prevention
- Canada's Food Guide: Advice on vitamin and mineral supplementation
- Canada's food guide: Nutrition considerations during pregnancy and to support breastfeeding
- SOGC: Folic Acid and Multivitamin Supplementation for Prevention of Folic Acid-Sensitive Congenital Anomalies
- Folic acid-containing supplement use among Canadian-born and immigrant women aged 15 to 55 years, 2015 to 2018, 2021
References and footnotes
NTD data come from the Canadian Congenital Anomalies Surveillance System (2025)Footnote 1. Data about folic acid supplementation come from Surveys and statistical programs- Canadian Community Health Survey - Annual Component (CCHS)Footnote 2.
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