What should you know about folate neural tube defects?

The neural tube is an early structure that develops into the brain and spinal cord. If it does not close normally, a neural tube defect can occur. Spina bifida affects the developing spine, while anencephaly affects major parts of the developing brain and skull. This development happens very early, sometimes before pregnancy is recognised. Folate, also called vitamin B9, is involved in cell growth and formation of this early structure. Taking folate does not explain why an individual defect occurred, and it cannot prevent every cause.

Discuss pregnancy planning with a clinician and ask which folate supplement and dose are appropriate for you. Start according to that advice before trying to conceive, and continue during the early part of pregnancy. Do not replace prescribed treatment with a general supplement without checking first. A varied diet can provide folate through leafy vegetables, beans, lentils, citrus fruit and fortified foods, but food alone may not provide the amount advised for pregnancy. Review medicines and health conditions before conception because some situations need personalised guidance. [Preconception Care](/treatments/pregnancy-and-birth-care/preconception-care/) can help with this planning.

Arrange pregnancy care promptly after a positive test, especially if you were not taking folate beforehand or have a health condition that affects nutrition or pregnancy planning. Ask about the timing of screening and the anomaly scan, which examines fetal development during pregnancy. Seek urgent medical help for severe bleeding, severe abdominal pain, fainting or feeling acutely unwell; these symptoms need assessment regardless of folate use.

Ask: Which folate dose is right for me? When should I start and stop it? Do my medicines or medical history change the advice? What screening will be offered, and when? How will an unexpected scan finding be explained and followed up?