Folic Acid Intake and Neural Tube Defects

Abstract

Neural tube defects (NTDs) are a group of congenital malformations with worldwide distribution and complex etiopathogenesis. Folic acid plays a pivotal role in their prevention. We aimed to identify the protective effect of folic acid intake against NTDs and its dependence on different socioeconomic and environmental factors in a cohort of mothers in Egypt.A cross-sectional study was carried over a period of 12 months on mothers who gave birth to babies with NTDs (group 1) and a control group with healthy offsprings (group 2). Both groups completed 2 questionnaires: food frequency questionnaire targeting the daily folate intake, and socioeconomic status and medical history questionnaire.Both groups of mothers received folate <800 μg/day, recommended for pregnant women. A strong association was detected between NTDs and urban residency with medium educated mothers, with negative consanguinity, who had folate intake < 400 μg daily, and who had their food long cooked. Each of these factors separately had a limited impact to cause NTDs, but when present together they did augment each other. Interestingly enough is the role of fava bean, cauliflower, spinach, and mango in predisposing of NTDs in the presence of the above-mentioned factors.The protective effect of folic acid intake against NTDs may depend on the synergism of different socioeconomic and environmental factors (which differ from country to another). In Egypt, females especially the medium-educated who live in urban areas should be well-informed with the value of folate intake in the periconceptional period.

Magnitude and determinants of neural tube defect in Africa: a systematic review and meta-analysis

“…Six studies [ 18 , 37 – 40 , 51 , 52 ] examined the association between folic acid supplementations before and within the first months of pregnancy. The pooled odds ratio indicated that women who have taken folic acid supplements before pregnancy and within the first month of pregnancy were 60% less likely to have newborns with neural tube defects (POR, 95% CI:0.4 (0.19–0.85)).…”

“…The association of paternal consanguineous marriage and neural tube defect was examined based on the findings from six studies [ 17 , 18 , 39 , 52 , 54 , 55 ]. The pooled odds ratio indicated that neural tube defects do not differ among parents with and without consanguineous marriages (POR, 95% CI: 1.42 (.62–3.23)).…”

Преконцепционна Употреба На Фолиева Киселина За Първична Профилактика На Редки Генетични Заболявания

“…ДНТ представляват група тежки вродени аномалии, които са свързани с висока смъртност, неблагоприятна прогноза и дългосрочни увреждания, както и със значителни емоционални, психологически и икономически последствия [4][5]. По данни на СЗО, почти всички (94%) тежки вродени дефекти възникват в слаборазвити страни, най-често поради недохранване на майката при експозиция на тератогенни фактори [6][7].…”

“…Времето за иницииране на прием при 1/3 от страните е най-малко 4 седмици преди зачеване. Въпреки че действащите препоръки се различават между отделните страни, препоръчителният прием на фолиева киселина от 400 µg дневно преди зачеване до първия триместър на бременността е еднакъв за повечето от тях (Таблица 1) [5,13,[24][25][26][27][28][29][30][31]. http://journal.raredis.org Христова Е, Искров Г, Стефанов Р. Преконцепционна употреба на фолиева киселина за първична профилактика на редки генетични заболявания.…”