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Folic acid supplementation and neural tube defect recurrence prevention.

Abstract

BACKGROUND

It is well established that women who have had a pregnancy affected by a neural tube defect (NTD) have an elevated risk of a subsequent NTD-affected pregnancy and that a high dose (4 mg/day) of folic acid taken around the time of conception prevents most recurrences of NTDs.

METHODS

We reviewed the literature to identify studies that quantify the reduction in risk if women with a prior-NTD affected pregnancy consistently take folic acid before and during a subsequent pregnancy and the effectiveness of NTD recurrence prevention programs in increasing the percentage of women who consistently consume folic acid supplements.

RESULTS

A meta-analysis of randomized trials of folic acid for the prevention of recurrent NTDs indicates a 69% reduction in recurrence risk if analyzed on an intention-to-treat basis and an 87% reduction among those women who took supplements prior to the beginning of pregnancy. Observational studies report reductions in recurrence risk of 85% to 100% among women taking folic acid prior to subsequent pregnancies. The percentage of women who take folic acid prior to a subsequent pregnancy has been reported to vary from 33% to 85%, varying with the demographic background and the intensity of folic acid counseling efforts.

CONCLUSIONS

Targeted folic acid information and counseling provided to women with an NTD-affected pregnancy has been demonstrated to substantially reduce the risk of recurrent NTDs and is feasible to implement on a public health basis.

Authors+Show Affiliations

National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.No affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

17990333

Citation

Grosse, Scott D., and Julianne S. Collins. "Folic Acid Supplementation and Neural Tube Defect Recurrence Prevention." Birth Defects Research. Part A, Clinical and Molecular Teratology, vol. 79, no. 11, 2007, pp. 737-42.
Grosse SD, Collins JS. Folic acid supplementation and neural tube defect recurrence prevention. Birth Defects Res Part A Clin Mol Teratol. 2007;79(11):737-42.
Grosse, S. D., & Collins, J. S. (2007). Folic acid supplementation and neural tube defect recurrence prevention. Birth Defects Research. Part A, Clinical and Molecular Teratology, 79(11), pp. 737-42.
Grosse SD, Collins JS. Folic Acid Supplementation and Neural Tube Defect Recurrence Prevention. Birth Defects Res Part A Clin Mol Teratol. 2007;79(11):737-42. PubMed PMID: 17990333.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Folic acid supplementation and neural tube defect recurrence prevention. AU - Grosse,Scott D, AU - Collins,Julianne S, PY - 2007/11/9/pubmed PY - 2008/1/30/medline PY - 2007/11/9/entrez SP - 737 EP - 42 JF - Birth defects research. Part A, Clinical and molecular teratology JO - Birth Defects Res. Part A Clin. Mol. Teratol. VL - 79 IS - 11 N2 - BACKGROUND: It is well established that women who have had a pregnancy affected by a neural tube defect (NTD) have an elevated risk of a subsequent NTD-affected pregnancy and that a high dose (4 mg/day) of folic acid taken around the time of conception prevents most recurrences of NTDs. METHODS: We reviewed the literature to identify studies that quantify the reduction in risk if women with a prior-NTD affected pregnancy consistently take folic acid before and during a subsequent pregnancy and the effectiveness of NTD recurrence prevention programs in increasing the percentage of women who consistently consume folic acid supplements. RESULTS: A meta-analysis of randomized trials of folic acid for the prevention of recurrent NTDs indicates a 69% reduction in recurrence risk if analyzed on an intention-to-treat basis and an 87% reduction among those women who took supplements prior to the beginning of pregnancy. Observational studies report reductions in recurrence risk of 85% to 100% among women taking folic acid prior to subsequent pregnancies. The percentage of women who take folic acid prior to a subsequent pregnancy has been reported to vary from 33% to 85%, varying with the demographic background and the intensity of folic acid counseling efforts. CONCLUSIONS: Targeted folic acid information and counseling provided to women with an NTD-affected pregnancy has been demonstrated to substantially reduce the risk of recurrent NTDs and is feasible to implement on a public health basis. SN - 1542-0752 UR - https://www.unboundmedicine.com/medline/citation/17990333/Folic_acid_supplementation_and_neural_tube_defect_recurrence_prevention_ L2 - https://doi.org/10.1002/bdra.20394 DB - PRIME DP - Unbound Medicine ER -