What additional folic acid dose is recommended for women with a history of neural tube defects?

Women with a history of neural tube defects are recommended to take an increased dose of folic acid to help reduce the risk of recurrence in future pregnancies. The standard recommendation for folic acid supplementation in the general population is 0.4 mg (400 mcg) per day during preconception and the first trimester. However, for women who have previously had a pregnancy affected by a neural tube defect, the recommended folic acid dosage increases significantly due to their higher risk.

The recommendation for these women is to take 4 mg (4000 mcg) of folic acid daily, starting at least one month before conception and continuing through the first trimester. This higher dose is based on evidence showing that increased levels of folic acid can significantly lower the risk of recurrence of neural tube defects, such as spina bifida or anencephaly, in subsequent pregnancies.

This recommendation is established in guidelines from health organizations like the Centers for Disease Control and Prevention (CDC) and the American College of Obstetricians and Gynecologists (ACOG), which emphasize the importance of adequate folic acid intake for women at increased risk. Therefore, a dose of 4 mg is the appropriate choice given the context of preventing neural tube defects in women with