In the UK, 90% of women of childbearing age have inadequate folate levels, increasing the risk of neural tube defects (NTDs). The UK Government has introduced mandatory folic acid fortification of non-wholemeal wheat flour, expected to prevent around 20% of NTDs.
Folate deficiency remains widespread, particularly among women from Black and South Asian backgrounds and those experiencing socioeconomic disadvantage. Supplement uptake is low, and almost half of pregnancies are unplanned, limiting opportunities for early prevention.
This project will analyse 2,000 early-pregnancy blood samples collected between 2025 and 2027 across four UK locations: South London, Bradford, Edinburgh, and Belfast. Samples will be assessed for folate, B12, homocysteine and related biomarkers to evaluate the impact of national folic acid fortification.
The study will generate robust evidence on changes in maternal folate status before, during and after fortification. It will assess whether benefits are equitably distributed and inform UK nutrition and maternal health policy.
Dr Kathryn Dalrymple, Lecturer in Nutritional Sciences, King’s College London