Overview

• Drawing on NHANES data from 2007 through March 2020, the CDC analyzed 5,374 non-pregnant women ages 12–49 and found 66% had at least one modifiable risk factor, with 10% having three or more.
• Measured risks included diabetes in 4.8% of women, obesity in about one in three, elevated serum cotinine indicating tobacco exposure in nearly one in five, and very low household food security in 7.3%.
• The share of women with low red blood cell folate declined from 23.4% in 2007 to 17.9% in 2020, reflecting gains associated with long-standing folic acid policies.
• Folic acid fortification of enriched grains is estimated to prevent more than 1,300 neural-tube-defect cases each year in the United States, according to the study authors.
• The authors emphasize preconception steps—such as taking 400 micrograms of folic acid daily, following a healthy diet and exercise plan, and controlling blood sugar—while noting the study focused on selected structural defects and established modifiable factors.