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dc.contributor.authorBotto, Lorenzo D
dc.contributor.authorLisi, Alessandra
dc.contributor.authorBower, Carol
dc.contributor.authorCanfield, Mark A
dc.contributor.authorDattani, Nirupa
dc.contributor.authorDe Vigan, Catherine
dc.contributor.authorDe Walle, Hermien
dc.contributor.authorErickson, David J
dc.contributor.authorHalliday, Jane
dc.contributor.authorIrgens, Lorentz M
dc.contributor.authorLowry, R Brian
dc.contributor.authorMcDonnell, Robert
dc.contributor.authorMetneki, Julia
dc.contributor.authorPoetzsch, Simone
dc.contributor.authorRitvanen, Annukka
dc.contributor.authorRobert-Gnansia, Elisabeth
dc.contributor.authorSiffel, Csaba
dc.contributor.authorStoll, Claude
dc.contributor.authorMastroiacovo, Pierpaolo
dc.date.accessioned2014-07-29T08:53:29Zen
dc.date.available2014-07-29T08:53:29Zen
dc.date.issued2006-10en
dc.identifier.citationBotto LD et al. Trends of selected malformations in relation to folic acid recommendations and fortification: an international assessment. Birth Defects Res. Part A Clin. Mol. Teratol. 2006, 76 (10):693-705en_GB
dc.identifier.issn1542-0752en
dc.identifier.pmid17029289en
dc.identifier.doi10.1002/bdra.20307en
dc.identifier.urihttp://hdl.handle.net/10147/323885en
dc.descriptionBACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.en_GB
dc.description.abstractTwo 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.
dc.description.abstractWe 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.
dc.description.abstractSignificant 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.
dc.description.abstractRecommendations 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.
dc.language.isoenen
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmed/17029289en_GB
dc.rightsArchived with thanks to Birth defects research. Part A, Clinical and molecular teratologyen_GB
dc.subjectFOLIC ACIDen_GB
dc.subject.meshDietary Supplementsen
dc.subject.meshEvaluation Studies as Topicen
dc.subject.meshFemaleen
dc.subject.meshFolic Aciden
dc.subject.meshFood, Fortifieden
dc.subject.meshGuidelines as Topicen
dc.subject.meshHumansen
dc.subject.meshInternational Cooperationen
dc.subject.meshMaleen
dc.subject.meshNeural Tube Defectsen
dc.subject.meshPregnancyen
dc.subject.meshPregnancy Complicationsen
dc.subject.meshRegistriesen
dc.subject.meshRetrospective Studiesen
dc.subject.otherBIRTH DEFECTSen_GB
dc.subject.otherNEURAL TUBE DEFECTSen_GB
dc.subject.otherDEPARTMENT OF PUBLIC HEALTHen
dc.subject.otherCONGENITAL ANOMALYen
dc.subject.otherHEALTH IMPROVEMENTen
dc.titleTrends of selected malformations in relation to folic acid recommendations and fortification: an international assessment.en_GB
dc.typeArticleen
dc.contributor.departmentDepartment of Pediatrics, University of Utah, Salt Lake City, Utah, USA.en_GB
dc.identifier.journalBirth defects research. Part A, Clinical and molecular teratologyen_GB
html.description.abstractTwo 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.
html.description.abstractWe 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.
html.description.abstractSignificant 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.
html.description.abstractRecommendations 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.


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