Reduction in neural-tube defects after folic acid fortification in Canada.

@article{DeWals2007ReductionIN,
  title={Reduction in neural-tube defects after folic acid fortification in Canada.},
  author={Philippe De Wals and Fassiatou Tairou and Margot I. Van Allen and S H Uh and R Brian Lowry and Barbara Sibbald and Jane A. Evans and Michiel C. Van Den Hof and Pamela Zimmer and Marian Crowley and Bridget Fernandez and Nora S. Lee and Theophile Niyonsenga},
  journal={The New England journal of medicine},
  year={2007},
  volume={357 2},
  pages={
          135-42
        }
}
BACKGROUND In 1998, folic acid fortification of a large variety of cereal products became mandatory in Canada, a country where the prevalence of neural-tube defects was historically higher in the eastern provinces than in the western provinces. We assessed changes in the prevalence of neural-tube defects in Canada before and after food fortification with folic acid was implemented. METHODS The study population included live births, stillbirths, and terminations of pregnancies because of fetal… 

Figures and Tables from this paper

Prevention of neural tube defects by the fortification of flour with folic acid: a population-based retrospective study in Brazil

The introduction of the mandatory fortification of flour with iron and folic acid in Brazil was followed by a significant reduction in the prevalence of neural tube defects in the study area.

Decline in the prevalence of neural tube defects following folic acid fortification and its cost-benefit in South Africa.

The decrease in NTD rates postfortification is consistent with decreases observed in other countries that have fortified their food supplies and the economic benefit flowing from the prevention of NTDs greatly exceeds the costs of implementing folic acid fortification.

Impact of flour fortification with folic acid on the prevalence of neural tube defects in Northern Iran

This study showed that flour fortification with folic acid is associated with a significant reduction in the rate of NTDs in Golestan province of Northern Iran.

Peru's national folic acid fortification program and its effect on neural tube defects in Lima.

Peruvian legislative requirements for folic acid fortification are below international (WHO) recommendations; birth prevalence of N TDs in Lima is higher than international benchmarks; and no decrease in NTDs following fortification of flour with folic Acid was observed.

Neural tube defects and maternal folate intake among pregnancies conceived after folic acid fortification in the United States.

In this study conducted among pregnancies conceived after mandatory folic acid fortification, the authors found little evidence of an association between neural tube defects and maternal folic Acid intake.

Maternal use of folic acid supplements and infant risk of neural tube defects in Norway 1999–2013

Vitamin use was associated with a significantly lower risk of neural tube defects in the second half of the study period, 2006–2013, but not in the first, which found no statistically significant association between vitamin use and Neural tube defects overall.

Effectiveness of Folic Acid Fortified Flour for Prevention of Neural Tube Defects in a High Risk Region

Flour fortification was associated with lower birth prevalence and burden of N TDs in economically developing regions with a high risk of NTDs in economies with ahigh risk of folate deficiency and Neural Tube Defects.

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.

Food Fortification and Decline in the Prevalence of Neural Tube Defects: Does Public Intervention Reduce the Socioeconomic Gap in Prevalence?

While food fortification is successful in reducing the prevalence of NTDs, it was not associated with removing the gap between high and low SES groups.
...

Incidence of open neural tube defects in Nova Scotia after folic acid fortification.

The recommendations for folic acid supplementation alone did not appear to succeed in reducing the incidence of open NTDs in Nova Scotia, whereas the fortification of grain products with folic Acid did result in a significant reduction in the incidence.

A comprehensive evaluation of food fortification with folic acid for the primary prevention of neural tube defects

Mandatory food fortification with folic acid was mandated in Canada in November 1998 and in women aged 19–44 years and in seniors from November 1997 to March 1998, and from November 2000 to March 2001 to assess the benefits and possible adverse effects.

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.

Improvements in the status of folate and cobalamin in pregnant Newfoundland women are consistent with observed reductions in the incidence of neural tube defects.

The status of both folate and cobalamin has significantly improved in the post-fortification era, concurrent with a significant reduction in the number of neural tube defects, from 4.67 to 1.01 per 1000 total births since 1997.

Pregnancy Planning: A Determinant of Folic Acid Supplements Use for the Primary Prevention of Neural Tube Defects

Evaluating women’s knowledge and beliefs with regard to folic acid; estimating the frequency of vitamin supplement consumption; and identifying its determinants during the periconception period indicate that further efforts are needed to inform the population and promote the optimal use of folic Acid supplements.

Declining Rate of Folate Insufficiency Among Adults Following Increased Folic Acid Food Fortification in Canada

There has been a significant decline in the prevalence of folate, but not vitamin B12 insufficiency, following Canadian folic acid food fortification, according to a retrospective cross-sectional study using a large Ontario laboratory database.

Pregnancy planning and folic acid supplement use: results from a survey in Quebec.

A promotion campaign selectively targeting women likely to plan a pregnancy could have a significant impact in reducing neural tube defect incidence.

Prevalence of neural tube defects in the province of Quebec, 1992.

A retrospective study of neural tube defects was carried out among elective terminations of pregnancies, stillbirths and live births to women residing in two regions of Quebec, in 1992, indicating a three-fold reduction in frequency during the last three decades.