Overview

• The analysis, published August 26 in the American Journal of Preventive Medicine, used NHANES data from 5,374 nonpregnant women ages 12–49 collected between 2007 and 2020.
• Investigators identified five changeable factors tied to higher risk: obesity, diabetes, tobacco exposure, food insecurity, and low folate status.
• Prevalence findings included about one-third with obesity, 4.8% with diabetes, nearly one in five with elevated serum cotinine indicating tobacco exposure, and 7.3% reporting very low household food security.
• Low blood folate status declined from 23.4% in 2007 to 17.9% in 2020, and CDC officials estimate folic acid fortification prevents more than 1,300 neural-tube defects each year.
• Authors note the cross-sectional design and focus on selected defects such as congenital heart defects and orofacial clefts, while experts point to recent CDC staffing pressures with some program layoffs temporarily paused by a court ruling.