ABSTRACT
The year 2016 marks the 25th anniversary of the seminal Medical Research Council (MRC) randomized trial that conclusively demonstrated a marked protection against the recurrence of a neural tube defect (NTD) affected pregnancy among previously affected mothers by the simple prophylactic treatment of folic acid supplements in the periconceptional period. NTDs are the largest group of anomalies of the central nervous system and are among the most significant congenital causes of morbidity and mortality in infants worldwide. It has been accepted for many years that NTDs have a multifactorial etiology, containing both environmental and genetic influences, and probably requiring an interaction of both elements for the defect to occur. The past 25 years has seen extensive literature on the role of folic acid in the prevention of NTDs, but the possible involvement of micronutrients and particularly folic acid in protection against these devastating defects had been suggested since the 1960s.
