Medicine is finally waking up to the benefits of pre conceptual care.

Women planning to get pregnant are being advised to take folic acid supplements before conception to reduce the risks of their babies suffering from spina bifida and other neural tube related conditions.

Hungarian researchers conducted a randomized, double blind study of almost 5000 women who went on to become pregnant (JAMA, 24 December 1992). Each was assigned to receive either a single tablet of vitamin supplement (containing 12 vitamins, including 0.8mg folic acid, four minerals, and three trace elements) or a trace element supplement (containing copper, manganese, zinc and low doses of vitamin C) daily for at least a month before conception.

The results showed that there were nearly 50 per cent fewer congenital malformations of all types among babies born to women taking the vitamin supplement. Six babies in the trace element group had neural tube defects, compared with none in the vitamin group.

Having earlier pooh poohed the usefulness of folic acid, the US Food and Drug Administration has now swung the other way and is suggesting that some foods should be fortified with folic acid (The Lancet, 12 December 1992). And in the UK, doctors are recommending women take folic acid supplements all through pregnancy, rather than just up to the first trimester, as suggested by the Department of Health.