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Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation.
N Engl J Med. 1992 Dec 24; 327(26):1832-5.NEJM

Abstract

BACKGROUND

The risk of recurrent neural-tube defects is decreased in women who take folic acid or multivitamins containing such during the periconceptional period. The extent to which folic acid supplementation can reduce the first occurrence of defects is not known.

METHODS

We conducted a randomized, controlled trial of periconceptional multivitamin supplementation to test the efficacy of this treatment in reducing the incidence of a first occurrence of neural-tube defects. Women planning a pregnancy (in most cases their first) were randomly assigned to receive a single tablet of a vitamin supplement (containing 12 vitamins, including 0.8 mg of folic acid; 4 minerals; and 3 trace elements) or a trace-element supplement (containing copper, manganese, zinc, and a very low dose of vitamin C) daily for at least one month before conception and until the date of the second missed menstrual period or later.

RESULTS

Pregnancy was confirmed in 4753 women. The outcome of the pregnancy (whether the fetus or infant had a neural-tube defect or congenital malformation) was known in 2104 women who received the vitamin supplement and in 2052 who received the trace-element supplement. Congenital malformations were significantly more prevalent in the group receiving the trace-element supplement than in the vitamin-supplement group (22.9 per 1000 vs. 13.3 per 1000, P = 0.02). There were six cases of neural-tube defects in the group receiving the trace-element supplement, as compared with none in the vitamin-supplement group (P = 0.029). The prevalence of cleft lip with or without cleft palate was not reduced by periconceptional vitamin supplementation.

CONCLUSIONS

Periconceptional vitamin use decreases the incidence of a first occurrence of neural-tube defects.

Authors+Show Affiliations

Department of Human Genetics and Teratology, National Institute of Hygiene, Budapest, Hungary.No affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

1307234

Citation

Czeizel, A E., and I Dudás. "Prevention of the First Occurrence of Neural-tube Defects By Periconceptional Vitamin Supplementation." The New England Journal of Medicine, vol. 327, no. 26, 1992, pp. 1832-5.
Czeizel AE, Dudás I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med. 1992;327(26):1832-5.
Czeizel, A. E., & Dudás, I. (1992). Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. The New England Journal of Medicine, 327(26), 1832-5.
Czeizel AE, Dudás I. Prevention of the First Occurrence of Neural-tube Defects By Periconceptional Vitamin Supplementation. N Engl J Med. 1992 Dec 24;327(26):1832-5. PubMed PMID: 1307234.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. AU - Czeizel,A E, AU - Dudás,I, PY - 1992/12/24/pubmed PY - 1992/12/24/medline PY - 1992/12/24/entrez SP - 1832 EP - 5 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 327 IS - 26 N2 - BACKGROUND: The risk of recurrent neural-tube defects is decreased in women who take folic acid or multivitamins containing such during the periconceptional period. The extent to which folic acid supplementation can reduce the first occurrence of defects is not known. METHODS: We conducted a randomized, controlled trial of periconceptional multivitamin supplementation to test the efficacy of this treatment in reducing the incidence of a first occurrence of neural-tube defects. Women planning a pregnancy (in most cases their first) were randomly assigned to receive a single tablet of a vitamin supplement (containing 12 vitamins, including 0.8 mg of folic acid; 4 minerals; and 3 trace elements) or a trace-element supplement (containing copper, manganese, zinc, and a very low dose of vitamin C) daily for at least one month before conception and until the date of the second missed menstrual period or later. RESULTS: Pregnancy was confirmed in 4753 women. The outcome of the pregnancy (whether the fetus or infant had a neural-tube defect or congenital malformation) was known in 2104 women who received the vitamin supplement and in 2052 who received the trace-element supplement. Congenital malformations were significantly more prevalent in the group receiving the trace-element supplement than in the vitamin-supplement group (22.9 per 1000 vs. 13.3 per 1000, P = 0.02). There were six cases of neural-tube defects in the group receiving the trace-element supplement, as compared with none in the vitamin-supplement group (P = 0.029). The prevalence of cleft lip with or without cleft palate was not reduced by periconceptional vitamin supplementation. CONCLUSIONS: Periconceptional vitamin use decreases the incidence of a first occurrence of neural-tube defects. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/1307234/Prevention_of_the_first_occurrence_of_neural_tube_defects_by_periconceptional_vitamin_supplementation_ L2 - http://www.nejm.org/doi/full/10.1056/NEJM199212243272602?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -