Update on prevention of folic acid-preventable spina bifida and anencephaly

BACKGROUND: The number of countries fortifying wheat and maize flour with folic acid has increased in the past 2 years. Folic acid prevents most cases of spina bifida and anencephaly by raising serum folate levels among women capable of bearing children, as does encouraging women to consume folic ac...

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Published in:Birth defects research. A Clinical and molecular teratology 2009-01, Vol.85 (1), p.102-107
Main Authors: Bell, Karen N., Oakley Jr, Godfrey P.
Format: Article
Language:English
Subjects:
anencephaly
Anencephaly - epidemiology
Anencephaly - prevention & control
birth defect surveillance
Dietary Supplements
Female
Flour - utilization
flour fortification
Folic Acid - administration & dosage
Food, Fortified - utilization
Global Health
Humans
Nutritional Requirements
Pregnancy
Program Evaluation
spina bifida
Spinal Dysraphism - epidemiology
Spinal Dysraphism - prevention & control
Triticum
Triticum aestivum
Zea mays
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Summary:BACKGROUND: The number of countries fortifying wheat and maize flour with folic acid has increased in the past 2 years. Folic acid prevents most cases of spina bifida and anencephaly by raising serum folate levels among women capable of bearing children, as does encouraging women to consume folic acid supplements prior to pregnancy. METHODS: The progress in preventing these serious birth defects can be measured by tracking the number of countries now fortifying and program coverage in each. Country estimates of the number of pregnancies affected by spina bifida and anencephaly are calculated using a prefortification birth prevalence baseline and estimates of the proportion prevented by wheat and maize flour fortified with folic acid. RESULTS: Current fortification programs are preventing about 22,000, or 9% of the estimated folic acid‐preventable spina bifida and anencephaly cases. This represents an annual global decrease of about 6,600 folic acid‐preventable spina bifida and anencephaly cases since 2006. CONCLUSIONS: The pace of preventing these serious birth defects can be accelerated if more countries require fortification of both wheat and maize flour and if regulators set fortification levels high enough to increase a woman's daily average consumption of folic acid to 400 mcg. Birth Defects Research (Part A), 2009. © 2008 Wiley‐Liss, Inc.
ISSN:1542-0752
1542-0760
DOI:10.1002/bdra.20504