Objectives: We conducted a case-control study to investigate the effectiveness of efforts to increase folate intake in Western Australia (WA) for the prevention of neural tube defects (NTD).
Methods: Case (36) and control (578) mothers completed questionnaires, from which their intake of folate from supplements and food (including fortified foods) was estimated.
Results: Almost one-third of women took folic acid supplements periconceptionally. Supplement use was associated with a non-significant 4% reduction in risk. For women not taking supplements, dietary sources of folate were protective, and most women obtained at least some folate from fortified food.
Conclusions: For the two-thirds of WA women not taking supplements, fortified food is an important source of folate for the prevention of NTD.
Implications: Greater promotion of foods currently allowed to be fortified with folate, or mandatory fortification, is needed to maximise prevention of NTD in Australia.