Introduction

Not since the introduction of mass immunization against rubella have Canadian health professionals had an opportunity to prevent congenital anomalies through public health policy. Nearly a decade ago, accumulated evidence on the effectiveness of folic acid, a B vitamin, in preventing neural tube defects (NTDs) resulted in North American recommendations for daily folic acid supplementation by women. Despite efforts by a number of organizations and governments to develop guidelines and recommendations on folic acid supplementation and disseminate this information, awareness among health professionals and members of the public about the benefits of folic acid in preventing NTDs remains low. Even fewer are effecting these changes in their daily lives and recommending similar action among their families and patients. ^{2 7}

In 1995, Health Canada sponsored a national workshop on the primary prevention of NTDs, bringing together various groups that were responding to the evidence on the health benefits of folic acid. ⁸ After this workshop, Health Canada prepared an Update on Reducing the Risk of Neural Tube Defects, which was published in Nutrition for a Healthy Pregnancy: National Guidelines for the Childbearing Years. ⁹ The Department also undertook to develop this resource document for health professionals in order to inform them about folic acid and NTDs. In turn, the informed health professional would be better able to educate his or her co-workers, patients and community, helping to effect change.

This document can be used in conjunction with other Health Canada publications, specifically Nutrition for a Healthy Pregnancy ⁹ and Canada's Food Guide to Healthy Eating, ¹⁰ as well as medical guidelines published by various Canadian medical organizations. ^11 14

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