A 2017 global update on folic acid‐preventable spina bifida and anencephaly

Kancherla, Vijaya; Wagh, Kaustubh; Johnson, Quentin; Oakley, Godfrey P.

doi:10.1002/bdr2.1366

Cited by 36 publications

(48 citation statements)

References 34 publications

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“…A systematic review (179 studies) and meta-analysis (123 studies) covering the prevalence of spina bifida in response to folic acid fortification status, geographic region, and study population indicate a lower prevalence of spina bifida in geographic regions with mandatory folic acid fortification (33.86 per 100,000 live births) versus voluntary fortification (48.35 per 100,000 live births) [20,21]. Based on 59 countries meeting the criteria of mandatory folic acid fortification of at least 1.0 ppm, it is estimated that 50,270 spina bifida and anencephaly births were prevented out of a possible 280,500 [22]. Overall, these reports suggest that national folic acid fortification protects against NTDs.…”

Section: Discussionmentioning

confidence: 99%

Folic Acid Fortification and Neural Tube Defect Risk: Analysis of the Food Fortification Initiative Dataset

Murphy

Westmark

2020

Nutrients

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The United States implemented mandatory fortification of cereal grains with folic acid in 1998 to prevent neural tube defects (NTDs) during pregnancy. The health benefits of folate (vitamin B9) are well documented; however, there are potential risks of exceeding the upper tolerable limit, particularly in vulnerable populations. We conducted a population-based analysis of the Food Fortification Initiative dataset to determine the strength of the evidence regarding reports of decreased NTDs at the national level in response to mandatory folic acid fortification of cereal grains. We found a very weak correlation between NTD prevalence and the level of folic acid fortification, irrespective of the cereal grain fortified (wheat, maize or rice). Stratification of the data based on socioeconomic status (SES) indicated a strong linear relationship between reduced NTDs and better SES. We conclude that national fortification with folic acid is not associated with a significant decrease in the prevalence of NTDs at the population level.

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Section: Discussionmentioning

confidence: 99%

Folic Acid Fortification and Neural Tube Defect Risk: Analysis of the Food Fortification Initiative Dataset

Murphy

Westmark

2020

Nutrients

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“…2. The ratio of live born, stillborn and eliminated Смоленская область 0 0,00 (0,00-0,67) 1 0,17 (0,03-0,98) 15 [2]. Общая частота дефектов нервной трубки по всем регистрам составила 10,13 на 10 тыс.…”

Section: результатыunclassified

“…в основном за счет обязательного обогащения пшеничной муки фолиевой кислотой [13][14][15]. В большинстве стран Европы, как и в Российской Федерации, основной способ первичной профилактики -применение фолиевой кислоты в периконцепционном периоде.…”

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Prevalence and time trends of neural tube defects in regions of the Russian Federation

Демикова

Подольная

Lapina

2020

Ross. vestn. perinatol. pediatr.

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Neural tube defects – a group of severe congenital malformations with a high level of mortality, childhood disability. The average prevalence of these defects is approximately 1 per 1000 births. The main measures to reduce the prevalence of neural tube defects are primary and secondary prevention measures, the effectiveness of which can be determined by congenital malformations monitoring.Research purpose. To determine the prevalence of neural tube defects, as well as trends in their prevalence for 2011 to 2017 in the Russian Federation according to monitoring of congenital malformations.Results. The total prevalence of anencephaly among newborns and fetuses was 4.63 (95% confidence interval - CI 4.40–4.88) per 10000 births, spina bifida – 6.18 (95% CI 5.91–6.46) and encephalocele 1.34 (95% CI 1.21–1.47). At the same time, the prevalence of anencephaly only among live births was 0.11 (95% CI 0.08–0.15) per 10000, spina bifida – 2.24 (95% CI 2.08–2.41) and encephalocele – 0 25 (95% CI 0.20–0.31). The decrease in prevalence of birth defects among live births compared with the total prevalence is provided by a high level of detection of these defects by ultrasound examination during pregnancy with the subsequent elimination of the affected fetuses. The maximum proportion of eliminated fetuses is observed for anencephaly (90.5%), for encephalocele the proportion of aborted fetuses is 77.4% and for spina bifida – 59.3%. Over the 7-year period, the multidirectional prevalence trends were noted: the increasing trend for total prevalence of neural tube defects and the decreasing trend for prevalence of these defects among live-born children.Conclusion. Estimates of the prevalence of neural tube defects in Russian Federation regions are obtained. The dynamics of the studied defects prevalence indicates that the decreasing of neural tube defects prevalence among live births is associated with secondary prevention measures.

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“…Folic acid supplementation has been successful in increasing blood folate levels and reducing NTD [4], but the typical approach of providing iron folic acid supplements during antenatal visits is limited because many women do not start consuming folic acid supplements until too late in pregnancy, when the embryo's neural tube has already been closed [5,6]. Food fortification has been shown to be effective in increasing blood folate levels and reducing NTD [7,8], but mixed results have been observed for iron deficiency (ID) and anemia [9], which could be explained by the choice of poorly bioavailable iron fortificants as well as a high consumption of iron-absorption inhibitors [10] or physiological conditions such as inflammation, which prevent iron absorption [11].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Anemia and Micronutrient Deficiencies among Women of Reproductive Age—The Impact of the Wheat Flour Fortification Program in Uzbekistan

Petry¹,

Nizamov²,

Woodruff³

et al. 2020

Nutrients

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Food fortification can be effective in reducing the prevalence of anemia and micronutrient deficiencies. This study assessed risk factors for-and the impact of the wheat flour program in Uzbekistan on-anemia, and iron and folate deficiency (FD) in non-pregnant women (NPW) of reproductive age. National data were analyzed for risk factors using multivariable regression. Additional iron intake from fortified flour was not associated with iron deficiency (ID) and did not result in a significantly different prevalence of anemia regardless of the levels, whereas women with additional folic acid intake had a lower relative risk (RR) of FD (RR: 0.67 [95% CI: 0.53, 0.85]). RR for anemia was greater in women with ID (RR: 4.7; 95% CI: 3.5, 6.5) and vitamin A insufficiency (VAI; RR 1.5; 95% CI: 1.3, 1.9). VAI (RR: 1.4 [95% CI: 1.3, 1.6]) and breastfeeding (RR: 1.1 [95% CI: 0.99, 1.2]) were associated with increased risk of ID, while being underweight reduced the risk (RR: 0.74 [95% CI: 0.58, 0.96]). Breastfeeding (RR: 1.2 [95% CI: 1.1, 1.4]) and inflammation (RR: 1.2 [95% CI: 1.0, 1.3]) increased risk of FD. FD results indicate that the fortification program had potential for impact, but requires higher coverage of adequately fortified wheat flour and a more bioavailable iron fortificant.

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A 2017 global update on folic acid‐preventable spina bifida and anencephaly

Cited by 36 publications

References 34 publications

Folic Acid Fortification and Neural Tube Defect Risk: Analysis of the Food Fortification Initiative Dataset

Folic Acid Fortification and Neural Tube Defect Risk: Analysis of the Food Fortification Initiative Dataset

Prevalence and time trends of neural tube defects in regions of the Russian Federation

Risk Factors for Anemia and Micronutrient Deficiencies among Women of Reproductive Age—The Impact of the Wheat Flour Fortification Program in Uzbekistan

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