Objective: Is folic acid supplementation for the prevention of neural tube defects effective? How could periconceptional folic acid supplementation be recommended in Germany and actually put into practice?
Methods: Analysis of the available literature and of the German health care system.
Results: According to the available data, it is likely that the rate of neural tube defects can be reduced by periconceptional folic acid. Matters of concern regarding its practical implementation are: difficulties regarding the information of the target group; the presently rare ingestion of vitamin supplements by women of child-bearing age in Germany; the lack of suitable folic acid preparations.
Conclusions: Several German societies have recommended folic acid supplements for women who plan to become pregnant: 4 mg for those at high risk (previous child with neural tube defect) and 0.4 mg/daily for women without a particular risk.