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Birth defects in Arkansas: is folic acid fortification making a difference?
Birth Defects Res A Clin Mol Teratol. 2004 Sep; 70(9):559-64.BD

Abstract

BACKGROUND

Since 1998, fortification of grain products with folic acid has been mandated in the United States, in an effort to reduce the prevalence of neural tube defects (NTDs). Published reports have shown a reduction in the prevalence of spina bifida since fortification was mandated, but no published studies have reported a reduction in birth defects, other than NTDs, that are postulated to be associated with folic acid deficiency. This study was performed to determine if fortification has reduced the prevalence of NTDs and other birth defects in Arkansas.

METHODS

Using data from the Arkansas Reproductive Health Monitoring System, prevalences were computed for thirteen specific birth defects with prior evidence supporting a protective effect of folic acid or multivitamins. Prevalences were calculated using data for live births to Arkansas residents for 1993-2000. Exposure to folic acid fortification was classified by birth year as "pre-fortification" (1993-1995), "transition" (1996-1998) or "post-fortification" (1999-2000). Logistic regression analysis was used to compute crude and adjusted prevalence odds ratios comparing the identified time periods.

RESULTS

Prevalences decreased between the pre- and post-fortification periods for spina bifida, orofacial clefts, limb reduction defects, omphalocele, and Down syndrome, but only the decrease in spina bifida was statistically significant (prevalence odds ratio 0.56; 95% confidence interval, 0.37, 0.83).

CONCLUSION

In Arkansas, the prevalence of spina bifida has decreased since folic acid fortification of foods was implemented. Similar studies by other birth defects surveillance systems are needed to confirm a preventive effect of fortification for malformations other than spina bifida.

Authors+Show Affiliations

Arkansas Center for Birth Defects Research and Prevention, College of Medicine, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock 72211, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15368553

Citation

Simmons, Caroline J., et al. "Birth Defects in Arkansas: Is Folic Acid Fortification Making a Difference?" Birth Defects Research. Part A, Clinical and Molecular Teratology, vol. 70, no. 9, 2004, pp. 559-64.
Simmons CJ, Mosley BS, Fulton-Bond CA, et al. Birth defects in Arkansas: is folic acid fortification making a difference? Birth Defects Res Part A Clin Mol Teratol. 2004;70(9):559-64.
Simmons, C. J., Mosley, B. S., Fulton-Bond, C. A., & Hobbs, C. A. (2004). Birth defects in Arkansas: is folic acid fortification making a difference? Birth Defects Research. Part A, Clinical and Molecular Teratology, 70(9), 559-64.
Simmons CJ, et al. Birth Defects in Arkansas: Is Folic Acid Fortification Making a Difference. Birth Defects Res Part A Clin Mol Teratol. 2004;70(9):559-64. PubMed PMID: 15368553.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Birth defects in Arkansas: is folic acid fortification making a difference? AU - Simmons,Caroline J, AU - Mosley,Bridget S, AU - Fulton-Bond,Cynthia A, AU - Hobbs,Charlotte A, PY - 2004/9/16/pubmed PY - 2005/2/9/medline PY - 2004/9/16/entrez SP - 559 EP - 64 JF - Birth defects research. Part A, Clinical and molecular teratology JO - Birth Defects Res. Part A Clin. Mol. Teratol. VL - 70 IS - 9 N2 - BACKGROUND: Since 1998, fortification of grain products with folic acid has been mandated in the United States, in an effort to reduce the prevalence of neural tube defects (NTDs). Published reports have shown a reduction in the prevalence of spina bifida since fortification was mandated, but no published studies have reported a reduction in birth defects, other than NTDs, that are postulated to be associated with folic acid deficiency. This study was performed to determine if fortification has reduced the prevalence of NTDs and other birth defects in Arkansas. METHODS: Using data from the Arkansas Reproductive Health Monitoring System, prevalences were computed for thirteen specific birth defects with prior evidence supporting a protective effect of folic acid or multivitamins. Prevalences were calculated using data for live births to Arkansas residents for 1993-2000. Exposure to folic acid fortification was classified by birth year as "pre-fortification" (1993-1995), "transition" (1996-1998) or "post-fortification" (1999-2000). Logistic regression analysis was used to compute crude and adjusted prevalence odds ratios comparing the identified time periods. RESULTS: Prevalences decreased between the pre- and post-fortification periods for spina bifida, orofacial clefts, limb reduction defects, omphalocele, and Down syndrome, but only the decrease in spina bifida was statistically significant (prevalence odds ratio 0.56; 95% confidence interval, 0.37, 0.83). CONCLUSION: In Arkansas, the prevalence of spina bifida has decreased since folic acid fortification of foods was implemented. Similar studies by other birth defects surveillance systems are needed to confirm a preventive effect of fortification for malformations other than spina bifida. SN - 1542-0752 UR - https://www.unboundmedicine.com/medline/citation/15368553/Birth_defects_in_Arkansas:_is_folic_acid_fortification_making_a_difference L2 - https://doi.org/10.1002/bdra.20063 DB - PRIME DP - Unbound Medicine ER -