Best Evidence Summary of Folic Acid Supplementation for Prevention of Neural Tube Defects in Women of Childbearing Age

Objectives: To summarize the best evidence regarding folic acid supplementation for preventing neural tube defects (NTDs) in women of childbearing age and to develop a structured evidence summary for guiding clinical practice. Methods: We systematically searched multiple databases and professional websites from January 1, 2013, to September 18, 2025. Sources included 7 databases (PubMed, Embase, CINAHL, Web of Science, CNKI, Wanfang, VIP) and 20 professional websites (e.g., Medlive, GIN, NICE, ACOG, UpToDate, Chinese Medical Knowledge Database, etc.). The search targeted clinical guidelines, expert consensuses, and recommended practices on folic acid supplementation for NTD prevention in women of childbearing age. The retrieved literature underwent quality assessment, evidence extraction, and summarization. Results: The review included 17 publications: 8 guidelines, 4 expert consensuses, and 5 recommended practices. From these, we synthesized 14 distinct evidence statements, organized into five thematic dimensions: risks of neural tube defects and the role of folic acid, time window of neural tube closure, timing and dosage of folic acid supplementation, relationship between dietary folic acid and folic acid tablets, and folic acid-related testing. Conclusions: his study synthesized the best available evidence regarding folic acid supplementation for preventing NTDs in women of childbearing age, providing an evidence-based foundation to inform clinical practice. Future implementation efforts should focus on integrating recommendations into electronic health systems, developing precision public health interventions, and employing visual aids for health education.