Lower rates of neural tube defects in Israel following folic acid supplementation policy

Reiss, Annie; Cohen, Matan J.; Kaliner, Ehud; Kapara, Efrat Gabai; Singer, Amihood; Grotto, Itamar; Gamzu, Ronni

doi:10.1016/j.ypmed.2020.106064

Cited by 7 publications

(5 citation statements)

References 23 publications

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“…In this regard, a long-term population-based study conducted at one of the CHS hospitals in Israel found prevalence of CHD of 24.6 per 1,000 live births (Robinson et al, 2019). In respect to neural tube defects, recent findings in Israel reported a rate of 11.2 cases per 10,000 live births following a folic-acid implementation policy (Reiss et al, 2020). As for VSD in particular, in the present study, the rate was slightly higher in infants of the control group than those of the ondansetron group.…”

Section: Discussionmentioning

confidence: 99%

Ondansetron Use During Pregnancy: Birth Defects and Obstetric Outcomes

et al. 2023

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Ondansetron is a widely administered medication for nausea and vomiting of pregnancy. Further examination of its teratogenic capacity is necessary. This study examines the association between ondansetron treatment during pregnancy and birth defects and adverse obstetric outcomes. Patient data were extracted from Clalit Health Services, Israel. A propensity-score analysis was performed matching those exposed to ondansetron with those who were not. Findings identified 774 women exposed to ondansetron, matched 1:1 with unexposed control patients. No significant differences were found between the groups for: cleft palate, cardiovascular congenital abnormalities, spina bifida occulta, preterm delivery, or small for gestational age. Ondansetron may be a useful and safe alternative as treatment for women who suffer from hyperemesis gravidarum and do not respond to other antiemetic drugs. Notwithstanding, additional prospectively designed research is needed to establish the safety of ondansetron treatment during pregnancy.

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Section: Discussionmentioning

confidence: 99%

Ondansetron Use During Pregnancy: Birth Defects and Obstetric Outcomes

et al. 2023

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“…One of the strongest changes is a rise in folic acid (Fig 5B). Folic acid supplements are taken in the months before conception by about half of the relevant population [34][35][36] . We reasoned that supplements such as folic acid, vitamin B-12 and iron might exert physiological effects on other test values.…”

Section: Tests Affected By Pregnancy Supplements Show Preconception D...mentioning

confidence: 99%

Pregnancy and postpartum dynamics revealed by millions of lab tests

Bär

Cohen

Kohanim

et al. 2023

Preprint

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Pregnancy involves dynamic alterations in most physiological systems. Delivery initiates a transition to postpartum recovery, which similarly exhibits widespread dynamic changes. Physiological dynamics during pregnancy and after delivery have not been systematically analyzed at high temporal resolution in a large human population. Here, we present a dynamic atlas of 78 laboratory tests with weekly time resolution, spanning the period from 20 weeks pre-conception until 80 weeks postpartum, totaling 45 million measurements from over half a million pregnancies. Tests exhibited discontinuities and rebound effects after delivery, and showed extended recovery times of up to a year postpartum. The accuracy of the data revealed effects of preconception supplements and intricate temporal responses to changes in blood volume and renal filtration rate. The dynamical data allowed discrimination between distinct mechanistic models of adaptation in the thyroid axis. These results provide a comprehensive dynamic portrait of the systems physiology of pregnancy.

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“…38,55 For studies on folic acid, details regarding the coverage and doses of folate supplementation were frequently not reported. 12,22,23,34…”

Section: Limitationsmentioning

confidence: 99%

“…[15][16][17][18][19][20][21] Multiple studies have demonstrated that adequate intake is necessary for normal nervous system development. 15,16,[22][23][24][25][26][27][28][29][30][31][32][33] Despite this, inadequate folate intake is common among pregnant women in LMICs and is associated with an increased incidence of congenital NTDs. Up to half of all NTDs are preventable by folic acid fortification, and periconceptional supplementation has been shown to decrease the prevalence of NTDs by up to 70%.…”

Section: Folatementioning

confidence: 99%

Comparative Scoping Review of Prenatal Care Resources for Families of Children With Spinal Dysraphism and Hydrocephalus in High-Income Countries and Low- and Middle-Income Countries

Jiang,

Kalluri,

Ran

et al. 2023

Neurosurgery

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BACKGROUND AND OBJECTIVES: Low- and middle-income countries (LMICs) face higher incidences and burdens of care for neural tube defects (NTDs) and hydrocephalus compared with high-income countries (HICs), in part due to limited access to neurosurgical intervention. In this scoping review, we aim to integrate studies on prenatal care, counseling, and surgical management for families of children with spinal dysraphism and hydrocephalus in LMICs and HICs. METHODS: PubMed, Embase, Global Index Medicus, and Web of Science electronic databases were searched for English language articles pertaining to prenatal care, counseling, and surgical management for families of children with spinal dysraphism and hydrocephalus in HICs and LMICs. Identified abstracts were screened for full-text review. Studies meeting inclusion criteria were reviewed in full and analyzed. RESULTS: Seventy studies met the inclusion criteria. Twelve studies (16.9%) were conducted in HICs only, 50 studies (70.4%) were conducted in LMICs only, and 9 studies (12.7%) encompassed both. On thematic analysis, seven underlying topics were identified: epidemiology, folate deficiency and supplementation/fortification, risk factors other than folate deficiency, prenatal screening, attitudes and perceptions about NTDs and their care, surgical management, and recommendations for guideline implementation. CONCLUSION: NTDs have become a widely acknowledged public health problem in many LMICs. Prenatal counseling and care and folate fortification are critical in the prevention of spinal dysraphism. However, high-quality, standardized studies reporting their epidemiology, prevention, and management remain scarce. Compared with NTDs, research on the prevention and screening of hydrocephalus is even further limited. Future studies are necessary to quantify the burden of disease and identify strategies for improving global outcomes in treating and reducing the prevalence of NTDs and hydrocephalus. Surgical management of NTDs in LMICs is currently limited, but pediatric neurosurgeons may be uniquely equipped to address disparities in the care and counseling of families of children with spinal dysraphism and hydrocephalus.

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Lower rates of neural tube defects in Israel following folic acid supplementation policy

Cited by 7 publications

References 23 publications

Ondansetron Use During Pregnancy: Birth Defects and Obstetric Outcomes

Ondansetron Use During Pregnancy: Birth Defects and Obstetric Outcomes

Pregnancy and postpartum dynamics revealed by millions of lab tests

Comparative Scoping Review of Prenatal Care Resources for Families of Children With Spinal Dysraphism and Hydrocephalus in High-Income Countries and Low- and Middle-Income Countries

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