SynthesisBMC nutrition2026
The effectiveness of mandatory folic acid fortification compared with pre-fortification periods on reducing neural tube defects (NTDs): a systematic review and meta-analysis.
Synthesis in BMC nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Reassessing Mandatory Folic Acid Fortification for Neural Tube Defect Prevention: Evidence, Uncertainty, and Policy Implications.Nutrients · 2026Review
- Natural Molecules for Brain Health and Resilience.International journal of molecular sciences · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNeural tube defects (NTDs) are serious birth defects of the brain and spine, with folic acid supplementation and fortification recognized as effective prevention strategies. While both approaches are widely used, there remains a debate about the relative effectiveness of mandatory folic acid fortification versus supplementation alone. This systematic review and meta-analysis assess the impact of mandatory folic acid fortification compared with pre-fortification periods on NTDs.
methodA comprehensive literature search was conducted to identify observational studies evaluating the impact of mandatory folic acid fortification on NTDs prevalence. Fourteen studies, encompassing over 33 million participants, met the inclusion criteria. The meta-analysis calculated pooled risk ratios (RR) to compare the effectiveness of fortification to the comparison group. Subgroup analyses were performed based on geographic location to explore potential regional variations in outcomes.
resultsThe pooled analysis revealed that mandatory folic acid fortification was associated with a 44% reduction in the risk of NTDs (RR = 0.56). Subgroup analyses demonstrated region-specific benefits: North American studies showed a 54% reduction in NTDs risk (RR = 0.46), while South American studies reported a 38.8% reduction (RR = 0.61). Therefore, mandatory folic acid fortification significantly reduces the risk of NTDs compared to pre-fortification. Continued implementation, alongside supplementation and rigorous monitoring, is crucial to further reduce the global incidence of NTDs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.