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Nutrition: For Babies, Going With the Grain By JOHN O'NEIL Published: March 2, 2004

Adding folic acid to breads and grains sold in the United States has cut by a third the number of fetuses at risk for birth defects caused by folic acid deficiency, a new study has concluded. Low folate levels early in pregnancy can cause birth defects called neural tube defects, including spina bifida.

The government required folic acid fortification in 1998, after efforts to persuade women of childbearing age to take folic acid supplements had not led to a decrease in the defects. The new study, led by Dr. Mark I. Evans of St. Luke's-Roosevelt Hospital Center in Manhattan, compared 27,000 pregnancies from 1997 and 34,000 from in 2000.

Earlier studies that counted neural tube defects among newborns indicated a drop of 19 percent, a smaller change than had been predicted. But Dr. Evans argued that because the studies could not account for stillbirths or terminated pregnancies, it would be better to measure the change using pregnancy screening tests. The number of women the tests found at high risk fell by 32 percent, and the number at highest risk had dropped by 44 percent, according to the study, in the March issue of the journal Obstetrics & Gynecology.

Dr. Evans wrote that the findings indicated that fortification "represented the biggest single step in the reduction of birth defects to date." Dr. James L. Mills, a specialist in the defects at the National Institutes of Health who was not connection with the research, agreed. He called Dr. Evans's findings in line with the 50 percent drop reported after fortification in Canada.