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Level II – Folic Acid Chemoprophylaxis Counseling

Level II Services: Preventive services for which clinicians and care systems should assess the need. These services should be recommended to each patient as they have value, but less than those in Level I.

The USPSTF recommendations are fully endorsed by the ICSI Preventive Services work group.
Grade of Recommendation and Level of Certainty as Evaluated by USPSTF
  1. “That all women planning or capable of pregnancy take a daily supplement containing 0.4 to 0.8 mg (400 to 800 µg) of folic acid.”
(USPSTF Last Revised 2009 – Update in Progress)
Grade of Recommendation:
  1. A

Level of Certainty:

  1. High
The USPSTF found convincing evidence that supplements containing 0.4 to 0.8 mg (400 to 800 µg) of folic acid in the periconceptional period reduce the risk for neural tube defects.
Adequate evidence suggests that folic acid from supplementation at usual doses is not associated with serious harms.
Benefits-Harms Assessment:
The USPSTF concludes that, for women who are planning or capable of pregnancy, there is high certainty that the net benefit is substantial.”
Relevant Resources: