The British Pregnancy Advisory Service (BPAS) is urging the UK's health ministers to implement recommendations to fortify flour with the vitamin folic acid to reduce cases of neural tube defects (NTDs) like spina bifida and anencephaly in pregnancy. There are an estimated 1,000 cases of these conditions diagnosed every year in the UK, not including miscarriages. Most of these diagnoses result in the difficult decision to end a much wanted pregnancy.
Spina bifida causes lifelong disability while anencephaly, where the baby's skull and brain do not form properly, is always fatal. The UK has one of the highest rates of neural tube defects in the European Union, and it has remained largely unchanged since the early 1990s.
To avoid NTDs, women are advised to take folic acid supplements before conception and up to 12 weeks into their pregnancy. But nearly half of pregnancies in this country are not planned, and so many women are not able to take these supplements at a point that has any impact on the healthy development of their foetus. The neural tube will have formed around the time a woman misses her first period.
Mandatory fortification of flour with folic acid would mean the vitamin entered everyday foods widely consumed by women of childbearing age. It could prevent a couple being told each day that their pregnancy is affected by an NTD.
It is seven years since the Scientific Advisory Committee on Nutrition (SACN) first recommended flour be fortified and the UK's chief medical officers considered and approved that recommendation. The UK has been adding calcium, thiamin, niacin and iron to wheat flour for more than 50 years so both the principles and the mechanics of fortification are already in place.
Countries which have introduced mandatory fortification, including the US and Canada, have seen a marked reduction in neural tube defects, with no evidence of adverse effects on the rest of the population. The decision to fortify now lies with the health ministers of England, Wales, Scotland and Northern Ireland.
Ann Furedi, chief executive of the British Pregnancy Advisory Service, said:
"Unplanned pregnancy is a fact of life and often a wonderful and welcome surprise, but it is unrealistic to expect women to be taking folic acid supplements on the basis that they might conceive. The fortification of flour with folic acid is a straightforward public health intervention which could spare hundreds of women every year from the painful decision to end a wanted pregnancy after a diagnosis of a neural tube defect.
"Many politicians problematize abortion but show little interest in addressing some of the issues which result in a woman needing to end a pregnancy. Whatever our differences on abortion, we should all be able to unite behind a simple measure with huge benefits. We call on the UK's health ministers to make the necessary changes to protect the health of pregnant women and their babies and we urge them to do this as a matter of urgency."