Policy statement on folic acid and neural tube defects

Toriello, Helga V.

doi:10.1097/gim.0b013e31821d4188

Cited by 30 publications

(15 citation statements)

References 57 publications

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“…The recommendations from various societies agree that all women of reproductive age should consume 0•4 mg (400 μg) of folic acid daily. The supplementation to prevent a neural tube defect (spina bifida and anencephaly) should start before pregnancy and continue for at least the first trimester (36,37) . n-3 long-chain PUFA There has been mounting evidence showing that n-3 LCPUFA play an important role in brain structure and function.…”

Section: Recommendations From Scientific Societiesmentioning

confidence: 99%

Effects of prenatal and/or postnatal supplementation with iron, PUFA or folic acid on neurodevelopment: update

et al. 2016

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Neurodevelopment has been linked, among other factors, to maternal and early infant diets. The objective of this review, which is part of the NUTRIMENTHE research project 'The effect of diet on the mental performance of children' (www.nutrimenthe.com), was to update current evidence on the effects of nutritional interventions such as iron, folic acid or n-3 long-chain polyunsaturated fatty acid (LCPUFA) supplementation during pregnancy and/or in early life on the mental performance and psychomotor development of children. In May 2014, we searched MEDLINE and The Cochrane Database of Systematic Reviews for relevant studies published since 2009. The limited updated evidence suggests that iron supplementation of infants may positively influence the psychomotor development of children, although it does not seem to alter their mental development or behaviour. The use of multivitamin-containing folic acid supplements during pregnancy did not benefit the mental performance of the offspring. Evidence from randomised controlled trials (RCT) did not show a clear and consistent benefit of n-3 LCPUFA supplementation during pregnancy and/or lactation on childhood cognitive and visual development. Caution is needed when interpreting current evidence, as many of the included trials had methodological limitations such as small sample sizes, high attrition rates, and no intention-to-treat analyses. Taken together, the evidence is still inconclusive. Large, high-quality RCT to assess the effects of supplementation with iron, LCPUFA or folic acid are still needed to further clarify the effects of these, and other nutrients, on neurodevelopment. Recent recommendations from scientific societies are briefly presented.

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Section: Recommendations From Scientific Societiesmentioning

confidence: 99%

Effects of prenatal and/or postnatal supplementation with iron, PUFA or folic acid on neurodevelopment: update

et al. 2016

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“…These guidelines recommend that women with a previous affected pregnancy and planning a subsequent pregnancy speak with their doctors about consuming 4.0 milligrams of folic acid daily, beginning a minimum of 1 month before conception and continuing through the first 3 months of pregnancy. These guidelines are referenced by other U.S. public health and medical organizations (ACOG, 2003; USPSTF, 2009; Toriello, 2011; Zolotor and Carlough, 2014). …”

Section: Introductionmentioning

confidence: 99%

Using state and provincial surveillance programs to reduce risk of recurrence of neural tube defects in the United States and Canada: A missed opportunity?

Flood¹,

Rienks

Flores

et al. 2016

Birth Defects Research

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Background Once a woman has had a fetus or infant affected with a neural tube defect (NTD), the risk of recurrence is approximately 3%. This risk can be significantly reduced by folic acid supplement consumption during the periconceptional period; however, this requires women at risk to be adequately informed about the appropriate dosage and timing of supplement intake before planning another pregnancy. As birth defects surveillance programs are tasked with identifying and documenting NTD-affected pregnancies and births, they are in a unique position to support recurrence prevention activities. Methods In 2015, we surveyed state and provincial birth defects surveillance programs to assess their NTD recurrence prevention activities. The online survey was sent to programs in 52 United States (U.S.) jurisdictions and all 13 provinces and territories in Canada. Findings were compared with a similar survey conducted in 2005 among U.S. programs. Results In 2015, of the 44 U.S. and Canadian surveillance programs that responded, only 9 programs (7 U.S. and 2 Canadian) reported currently having activities specifically directed toward preventing NTD recurrence. Compared with a 2005 survey of U.S. programs, the number of U.S. programs working on NTD recurrence prevention decreased by almost 50% (from 13 to 7 programs). Conclusion The number of birth defects surveillance programs with NTD recurrence prevention activities has decreased over the past decade due to a range of barriers, most notably a lack of resources. However, while some recurrence prevention activities require part-time staff, other activities could be accomplished using minimal resources.

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“…The exact pathogenesis of these conditions is unknown. However, several risk factors for spina bifida and anencephaly have been consistently identified, including: family history (reviewed in Mitchell,2005; Lupo et al,2010a), female sex (Seller,1987; Shaw et al,2003), as well as maternal folate status and folic acid intake (Bailey et al,2003; Toriello,2011), Hispanic ethnicity (Canfield et al,2006; Feuchtbaum et al,1999), obesity (Waller et al,1994; Shaw et al,1996), pregestational and gestational diabetes (Becerra et al,1990; Correa et al,2008; Canfield et al,2009; Lupo et al,2010a), anticonvulsant use (Lammer et al,1987; Rosa,1991), and hyperthermia (Milunsky et al,1992; Shaw et al,1998; Duong et al,2011). While these associations are established or strongly suspected, the predictive ability of these risk factors has not been evaluated in combination.…”

Section: Introductionmentioning

confidence: 99%