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

Background Nuevo León is a state in northeastern Mexico, near the border of Texas. Mean mortality rate from 1996–98 due to anencephaly cases was 0.6/1,000. In 1999 a surveillance program for the registry and prevention of neural tube defects (NTD) cases was initiated. Methods Cases were obtained fro...

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Published in:Teratology (Philadelphia) 2002-11, Vol.66 (5), p.249-256
Main Authors: Martínez de Villarreal, Laura, Pérez, Jesús Z. Villarreal, Vázquez, Patricia Arredondo, Herrera, Ricardo Hernández, Campos, Ma. Del Roble Velazco, López, Roberto Ambriz, Ramírez, José Luis Herrera, Sánchez, Jesús Manuel Yañez, Villarreal, Juan José Morales, Garza, Manuel Treviño, Limón, Adriana, López, Abel Guzmán, Bárcenas, Mario, García, Juan Ramón Cepeda, Domínguez, Andrés Sánchez, Nuñez, Rogelio Hernández, Ayala, Jorge Luis García, Martínez, Jorge Garza, González, Mario Tijerina, Alvarez, Carlos García, Castro, Roberto Negrete
Format: Article
Language:English
Subjects:
Anencephaly - epidemiology
Anencephaly - prevention & control
Biological and medical sciences
Dietary Supplements
Encephalocele - epidemiology
Encephalocele - prevention & control
Female
Folic Acid - therapeutic use
Humans
Male
Malformations of the nervous system
Medical sciences
Mexico - epidemiology
Neural Tube Defects - epidemiology
Neural Tube Defects - prevention & control
Neurology
Population Surveillance
Pregnancy
Pregnancy Outcome - epidemiology
Prenatal Care
Prevalence
Registries
Rural Population
Sex Factors
Spinal Dysraphism - epidemiology
Spinal Dysraphism - prevention & control
Urban Population
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Summary:Background Nuevo León is a state in northeastern Mexico, near the border of Texas. Mean mortality rate from 1996–98 due to anencephaly cases was 0.6/1,000. In 1999 a surveillance program for the registry and prevention of neural tube defects (NTD) cases was initiated. Methods Cases were obtained from hospitals and OB‐GYN clinics by immediate notification, death certificates, or fetal death registries. Only isolated cases of NTD were included. In August 1999 a folic acid campaign was initiated with the free distribution of the vitamin to low‐income women with a recommendation to take a 5.0‐mg pill once a week. Number of cases and rates from 1999 to 2001 were compared (χ2 test). Results After 2 years there has been a significant reduction in the number of cases and rates. In 1999 there were 95 NTD cases and in the years 2000 and 2001 there were only 59 and 55 respectively (P < 0.001). NTD rate decreased from 1.04/1,000 in 1999 to 0.58/1,000 in 2001. Anencephaly and spina bifida rates decreased from 0.55/1,000 to 0.29/1,000 and from 0.47/1,000 to 0.22/1,000 respectively, from 1999–2001. Decrease of female cases was higher than male cases for both phenotypes. Conclusion 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. These results encourage us to propose the use of a single tablet of 5.0‐mg of folic acid per week as an alternative to supplementation on a daily basis. Teratology 66:249–256, 2002. © 2002 Wiley‐Liss, Inc.
ISSN:0040-3709
1096-9926
DOI:10.1002/tera.10094