Trends of selected malformations in relation to folic acid recommendations and fortification: an international assessment.
Botto, Lorenzo D Lisi, Alessandra Bower, Carol Canfield, Mark A Dattani, Nirupa De Vigan, Catherine De Walle, Hermien Erickson, David J Halliday, Jane Irgens, Lorentz M
Botto, Lorenzo D
Lisi, Alessandra
Bower, Carol
Canfield, Mark A
Dattani, Nirupa
De Vigan, Catherine
De Walle, Hermien
Erickson, David J
Halliday, Jane
Irgens, Lorentz M
Citations
Altmetric:
Author
Botto, Lorenzo D
Lisi, Alessandra
Bower, Carol
Canfield, Mark A
Dattani, Nirupa
De Vigan, Catherine
De Walle, Hermien
Erickson, David J
Halliday, Jane
Irgens, Lorentz M
Lowry, R Brian
McDonnell, Robert
Metneki, Julia
Poetzsch, Simone
Ritvanen, Annukka
Robert-Gnansia, Elisabeth
Siffel, Csaba
Stoll, Claude
Mastroiacovo, Pierpaolo
Lisi, Alessandra
Bower, Carol
Canfield, Mark A
Dattani, Nirupa
De Vigan, Catherine
De Walle, Hermien
Erickson, David J
Halliday, Jane
Irgens, Lorentz M
Lowry, R Brian
McDonnell, Robert
Metneki, Julia
Poetzsch, Simone
Ritvanen, Annukka
Robert-Gnansia, Elisabeth
Siffel, Csaba
Stoll, Claude
Mastroiacovo, Pierpaolo
Advisors
Editors
Other Contributors
Date
2006-10
Date Submitted
Keywords
FOLIC ACID
Other Subjects
BIRTH DEFECTS
NEURAL TUBE DEFECTS
DEPARTMENT OF PUBLIC HEALTH
CONGENITAL ANOMALY
HEALTH IMPROVEMENT
NEURAL TUBE DEFECTS
DEPARTMENT OF PUBLIC HEALTH
CONGENITAL ANOMALY
HEALTH IMPROVEMENT
Subject Mesh
Dietary Supplements
Evaluation Studies as Topic
Female
Folic Acid
Food, Fortified
Guidelines as Topic
Humans
International Cooperation
Male
Neural Tube Defects
Pregnancy
Pregnancy Complications
Registries
Retrospective Studies
Evaluation Studies as Topic
Female
Folic Acid
Food, Fortified
Guidelines as Topic
Humans
International Cooperation
Male
Neural Tube Defects
Pregnancy
Pregnancy Complications
Registries
Retrospective Studies
Planned Date
Start Date
Collaborators
Principal Investigators
Alternative Titles
Publisher
Abstract
Two crucial issues relative to the benefits and impact of folic acid in the prevention of birth defects are whether supplementation recommendations alone, without fortification, are effective in reducing the population-wide rates of neural tube defects (NTDs), and whether such policies can reduce the occurrence of other birth defects. Using data from 15 registries, we assessed rates and trends of 14 major defects, including NTDs, in areas with official recommendations or fortification to assess the effectiveness of recommendations and fortification on a wide range of major birth defects.
We evaluated surveillance data through 2003 on major birth defects from population-based registries from Europe, North America, and Australia. All included ascertainment of pregnancy terminations (where legal). Trends before and after policies or fortification were assessed via Poisson regression and were compared via rate ratios.
Significant changes in trends were seen for NTDs in areas with fortification but not in areas with supplementation recommendations alone. For other major birth defects, there was an overall lack of major trend changes after recommendations or fortification. However, some significant declines were observed for select birth defects in individual areas.
Recommendations alone remain an ineffective approach in translating the known protective effect of folic acid in population-wide decline in NTD rates. Fortification appears to be effective in reducing NTDs. The effect on other birth defects remains unclear.
We evaluated surveillance data through 2003 on major birth defects from population-based registries from Europe, North America, and Australia. All included ascertainment of pregnancy terminations (where legal). Trends before and after policies or fortification were assessed via Poisson regression and were compared via rate ratios.
Significant changes in trends were seen for NTDs in areas with fortification but not in areas with supplementation recommendations alone. For other major birth defects, there was an overall lack of major trend changes after recommendations or fortification. However, some significant declines were observed for select birth defects in individual areas.
Recommendations alone remain an ineffective approach in translating the known protective effect of folic acid in population-wide decline in NTD rates. Fortification appears to be effective in reducing NTDs. The effect on other birth defects remains unclear.
Language
en
ISSN
1542-0752
eISSN
ISBN
DOI
10.1002/bdra.20307
PMID
17029289