A decreasing rate of neural tube defects following the recommendations for periconceptional folic acid supplementation

  title={A decreasing rate of neural tube defects following the recommendations for periconceptional folic acid supplementation},
  author={Anne Klusmann and Beate Heinrich and Heike St{\"o}pler and Jutta G{\"a}rtner and Ertan Mayatepek and R{\"u}diger von Kries},
  journal={Acta P{\ae}diatrica},
Background/aim: Neural tube defects (NTDs) are the most common birth defects, resulting in severe mortality and morbidity. In 1995, the supplementation of folic acid periconceptionally was officially recommended in Germany. The impact of the recommendations on the rate of NTDs was assessed. 

Folic Acid and Other Potential Measures in the Prevention of Neural Tube Defects

  • H. Heseker
  • Medicine
    Annals of Nutrition and Metabolism
  • 2011
It is shown that not all cases of NTD can be prevented by increasing the folate intake, and the magnitude of the decline depends on the initial NTD rate.

Not all cases of neural-tube defect can be prevented by increasing the intake of folic acid

It is shown that not all cases of NTD are preventable by increasing the folate intake, and countries with NTD prevalence close to the observed floor may have much smaller reductions in NTD rates with folic acid fortification.

Epidemiology of neural tube defects

Despite the implementation of fortification of flour with folic acid since 2001, the prevalence of NTDs in the Kingdom of Saudi Arabia is still high, due to the impact of genetic, syndromic, and chromosomal causes of N TD not preventable by folic Acid.

Trends of selected malformations in relation to folic acid recommendations and fortification: an international assessment.

Recommendations alone remain an ineffective approach in translating the known protective effect of folic acid in population-wide decline in NTD rates, but fortification appears to be effective in reducing NTDs.

Awareness and Intake of Folic Acid for the Prevention of Neural Tube Defects Among Lebanese Women of Childbearing Age

Age, higher education level and stability/sufficiency of income appeared to be significant predictors of awareness among Lebanese women and actual folic acid intake was significantly associated with younger age, higher number of pregnancies, planning the last pregnancy and having had that last one after 1990.

Describing the Prevalence of Neural Tube Defects Worldwide: A Systematic Literature Review

A systematic review and search for NTD prevalence estimates and abstracted data from peer-reviewed literature, birth defects surveillance registries, and reports published between January 1990 and July 2014 highlighted the need for greater NTD surveillance efforts, especially in lower-income countries.

Final results from 18 years of the International Lamotrigine Pregnancy Registry

With over 1,500 first-trimester monotherapy exposures, the Registry was powered to detect major teratogenicity and failed to observe an increased MCM frequency with increasing lamotrigine dose.

Plasma folate levels and associated factors in women planning to become pregnant in a population with high prevalence of neural tube defects.

Women who planned to become pregnant had very low plasma folate in the population, and high NTD risk would remain if women would get pregnant without having taken folic acid supplements.

Plasma folate levels in early to mid pregnancy after a nation-wide folic acid supplementation program in areas with high and low prevalence of neural tube defects in China.

  • Jufen LiuLili Gao A. Ren
  • Medicine
    Birth defects research. Part A, Clinical and molecular teratology
  • 2015
Plasma folate levels among pregnant Chinese women increased dramatically after the nation-wide folic acid supplementation program in both rural and urban areas, and in populations of high and low NTD prevalence.


It can be concluded that most of the affected newborns were full term, with a slight male predominance, and the incidence of neurological abnormalities was higher than other types of birth defects.



Correction: Prevention of Neural-Tube Defects with Folic Acid in China.

Evaluated the outcomes of pregnancy in women who were asked to take a pill containing 400 μg of folic acid alone daily from the time of their premarital examination until the end of their first trimester of pregnancy, and identified 102 and 173 women with neural-tube defects.

Diagnosis and prevention of neural tube defects

Food fortification is the most practical way of ensuring sufficient folate supplementation and is warranted during the periconceptional period of neural tube defects, and therefore improved medical counseling and parents' decision making.

Impact of folic acid fortification of the US food supply on the occurrence of neural tube defects.

A 19% reduction in NTD birth prevalence occurred following folic acid fortification of the US food supply, however, factors other than fortification may have contributed to this decline.

Prevalence of neural tube defects in 20 regions of Europe and the impact of prenatal diagnosis, 1980-1986. EUROCAT Working Group.

  • H. Dolk
  • Medicine
    Journal of epidemiology and community health
  • 1991
There is considerable regional variation in the impact of prenatal diagnosis in terms of frequency and timing of diagnosis and pregnancy termination linked to different policies and practices of prenatal screening.

Dietary folate as a risk factor for neural‐tube defects: evidence from a case‐control study in Western Australia

The hypothesis that the dietary intake of folate in early pregnancy protects against the occurrence of isolated neural‐tube defects in infants is supported, and trends were seen when total folate intake was the exposure variable.

Involvement of deprivation and environmental lead in neural tube defects: a matched case-control study

There is evidence to suggest that lead is one cause of neural tube defects, especially anencephaly, which could link the known preventive actions of hard water and folic acid.

Application of capture-recapture methods for disease monitoring: potential effects of imperfect record linkage.

  • H. Brenner
  • Computer Science
    Methods of information in medicine
  • 1994
A simple correction procedure to overcome potential overestimation by false-negative matches is outlined and a quantitative assessment is given of the performance of the two-source capture-recapture method for disease monitoring in the presence of imperfect record linkage.

Pädiatrische Epidemiologie in Deutschland: Forschungsinstrument ESPED (Erhebungseinheit für seltene pädiatrische Erkrankungen in Deutschland)

ZusammenfassungHintergrund. Im Juli 1992 wurde die ESPED-Erhebungseinheit gegründet. In vorliegender Studie wurde untersucht, wie gut Compliance und wissenschaftlicher Impact sind und ob sich mit