Decline in the Prevalence of Spina Bifida and Anencephaly by Race/Ethnicity: 1995–2002

@article{Williams2005DeclineIT,
  title={Decline in the Prevalence of Spina Bifida and Anencephaly by Race/Ethnicity: 1995–2002},
  author={Laura J Williams and Sonja A. Rasmussen and Alina L Flores and Russell S. Kirby and Larry D. Edmonds},
  journal={Pediatrics},
  year={2005},
  volume={116},
  pages={580 - 586}
}
Objective. In an effort to reduce the occurrence of neural tube defects (NTDs), folic acid fortification of US enriched grain products was authorized by the Food and Drug Administration in March 1996 and required by January 1998. Fortification has been shown to result in an important decline in the prevalence of spina bifida and anencephaly in the general US population; however, fortification's impact on specific racial/ethnic groups has not been well described. We sought to characterize the… 

Figures and Tables from this paper

Trends in the postfortification prevalence of spina bifida and anencephaly in the United States.

TLDR
While the prevalences of spina bifida and anencephaly in the United States have declined since folic acid fortification in the food supply began, these data suggest that reductions in the prevalence of anENCEphaly continued during 2001-2004 and that racial and ethnic and other disparities remain.

Racial/ethnic differences in the birth prevalence of spina bifida - United States, 1995-2005.

TLDR
This report summarizes the results of that analysis, which indicated that from the early postfortification period, 1999--2000, to the most recent period of analysis, 2003--2005, the prevalence of spina bifida declined 6.9%, while prevalence among infants with non-Hispanic white and Hispanic mothers remained nearly constant.

The prevalence and predictors of anencephaly and spina bifida in Texas.

TLDR
Hispanic ethnicity was an important predictor for anencephaly, along with sex, maternal age, parity and border residence, however, only border residence and delivery year were significant predictors for spina bifida.

Anencephaly and spina bifida among Hispanics: maternal, sociodemographic, and acculturation factors in the National Birth Defects Prevention Study.

TLDR
Less acculturated Hispanic parents seemed to be at highest risk of NTDs, and spina bifida and anencephaly appeared to be etiologically heterogeneous from these analyses.

Prevalence of Neural Tube Defects, Folate Status, and Folate Fortification of Enriched Cereal-Grain Products in the United States

TLDR
Results suggested that folate fortification was associated with significant decreases in the prevalence of spina bifida among non-Hispanic white and Hispanic births (34% and 36% decreases, respectively) and folic acid fortification levels in the United States are too low.

Prevalence of Spina Bifida Among Children and Adolescents in 10 Regions in the United States

TLDR
The prevalence estimates of spina bifida among children and adolescents varied according to region, race/ethnicity, and gender, which suggests possible variations in prevalence at birth and/or inequities in survival rates.

Spina bifida subtypes and sub‐phenotypes by maternal race/ethnicity in the National Birth Defects Prevention Study

TLDR
Evidence is provided that certain spina bifida subtypes and sub‐phenotypes may be etiologically distinct, as well as race/ethnicity, among offspring of non‐Hispanic (NH) White mothers and offspring of Hispanic mothers.

An increase in spina bifida cases in Tunisia, 2008-2011.

Global Birth Prevalence of Spina Bifida by Folic Acid Fortification Status: A Systematic Review and Meta-Analysis.

TLDR
This extensive literature review shows that spina bifida is significantly more common in world regions without government legislation regulating full-coverage folic Acid fortification of the food supply and that mandatory folic acid fortification resulted in a lower prevalence of spina Bifida regardless of the type of birth cohort.
...

References

SHOWING 1-10 OF 61 REFERENCES

Prevalence of spina bifida and anencephaly during the transition to mandatory folic acid fortification in the United States.

TLDR
The decline in the prevalence of spina bifida was temporally associated with folic acid fortification of US grain supplies and the temporal association between fortification and the prevalenceof anencephaly is unclear.

Surveillance for anencephaly and spina bifida and the impact of prenatal diagnosis--United States, 1985-1994.

  • J. CraganH. Roberts J. Dean
  • Medicine
    MMWR. CDC surveillance summaries : Morbidity and mortality weekly report. CDC surveillance summaries
  • 1995
TLDR
This report presents data from birth defects surveillance systems in six states over different time periods and indicates that the impact of prenatal diagnosis and subsequent pregnancy termination on the prevalence at birth of anencephaly and spina bifida differs among geographic areas and populations.

Spina bifida and anencephaly before and after folic acid mandate--United States, 1995-1996 and 1999-2000.

  • Medicine
    MMWR. Morbidity and mortality weekly report
  • 2004
TLDR
The results of that analysis indicate that the estimated number of NTD-affected pregnancies in the United States declined from 4,000 to 3,000 in 1999-2000, highlighting the partial success of the U.S. folic acid fortification program as a public health strategy.

Hispanic origin and neural tube defects in Houston/Harris County, Texas. I. Descriptive epidemiology.

TLDR
The higher anencephaly rates among Hispanics, African-Americans, and those using public hospitals in an era of NTD screening, prenatal diagnosis, and elective pregnancy termination suggest that socioeconomic and perhaps cultural/religious factors might influence the recorded birth prevalence of this defect in particular groups.

Are women with recent live births aware of the benefits of folic acid

TLDR
Overall, PRAMS data indicated an increase in folic acid awareness among women with recent deliveries, however, this awareness might be too late for the pregnancy that has occurred, indicating a continued need to educate all reproductive-aged women regarding the need to take folic Acid before they become pregnant.

Are women with recent live births aware of the benefits of folic acid?

  • I. AhluwaliaK. L. Daniel
  • Medicine
    MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports
  • 2001
TLDR
Overall, PRAMS data indicated an increase in folic acid awareness among women with recent deliveries, however, this awareness might be too late for the pregnancy that has occurred, indicating a continued need to educate all reproductive-aged women regarding the need to take folic Acid before they become pregnant.

Decline of neural tube defects cases after a folic acid campaign in Nuevo León, México.

TLDR
After 2 years there was a 50% decrease in the incidence of anencephaly and spina bifida cases with a significant reduction of infant mortality and disability and these results encourage the use of a single tablet of 5.0-mg of folic acid per week as an alternative to supplementation on a daily basis.

Neural tube defect prevalence in California (1990-1994): eliciting patterns by type of defect and maternal race/ethnicity.

TLDR
Considerable variation exists in the prevalence of N TDs by race/ethnicity and by type of NTD, with Hispanic women exhibiting the highest overall NTD rate.

Folate status in women of childbearing age, by race/ethnicity--United States, 1999-2000, 2001-2002, and 2003-2004.

  • Medicine
    MMWR. Morbidity and mortality weekly report
  • 2007
TLDR
Comparisons of trends in serum folate and red blood cell (RBC) folate levels by race/ethnicity from the 1999--2000 survey through the 2003-2004 survey indicated that median folate concentrations among nonpregnant women of childbearing age decreased 16% from 1999-2000 through 2003- 2004, and RBC folate concentration decreased 8%.
...