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Neural tube defects in Australia: trends in encephaloceles and other neural tube defects before and after promotion of folic acid supplementation and voluntary food fortification.
Birth Defects Res A Clin Mol Teratol. 2009 Apr; 85(4):269-73.BD

Abstract

BACKGROUND

Use of periconceptional folic acid supplementation has been promoted in Western Australia since late 1992, and voluntary fortification of some foods with folic acid has been permitted in Australia since 1996. Reduced rates of neural tube defects (NTDs) have been observed since 1995. Aboriginal infants have a higher rate of NTDs, but no fall in rates has been documented. Encephaloceles have not been examined separately.

METHODS

Data on anencephaly, spina bifida, and encephalocele were obtained from the Western Australian Birth Defects Registry. The prevalence ratio for each type of NTD was calculated, comparing 1993 to 1995 (promotion of supplements, no fortification) and 1996 to 2006 (promotion of supplements and voluntary fortification) with 1980 to 1992 (no promotion or fortification).

RESULTS

From 1996 to 2006, there was a 32% reduction in anencephaly, 23% in spina bifida, and 34% in encephalocele compared with 1980 to 1992. There were no differences seen from 1993 to 1995 compared with 1980 to 1992. For Aboriginal infants, the rates were higher than for non-Aboriginal infants, for each type of NTD. The prevalence ratios, comparing 1996 to 2006 with 1980 to 1995, were 0.70 (CI, 0.61-0.79) for non-Aboriginal infants and 0.90 (CI, 0.61-1.32) for Aboriginal infants.

CONCLUSIONS

Overall, the rates of encephalocele, anencephaly, and spina bifida have fallen to a similar extent in association with promotion of folic acid supplements and voluntary fortification. No such falls were seen for Aboriginal infants. These data will provide a useful baseline against which to monitor the effects of mandatory fortification on NTDs when it is introduced in Australia in September 2009.

Authors+Show Affiliations

Western Australian Birth Defects Registry, Women and Newborn Health Service, King Edward Memorial Hospital, Subiaco, Western Australia. caroline.bower@health.wa.gov.auNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

19180646

Citation

Bower, Carol, et al. "Neural Tube Defects in Australia: Trends in Encephaloceles and Other Neural Tube Defects Before and After Promotion of Folic Acid Supplementation and Voluntary Food Fortification." Birth Defects Research. Part A, Clinical and Molecular Teratology, vol. 85, no. 4, 2009, pp. 269-73.
Bower C, D'Antoine H, Stanley FJ. Neural tube defects in Australia: trends in encephaloceles and other neural tube defects before and after promotion of folic acid supplementation and voluntary food fortification. Birth Defects Res Part A Clin Mol Teratol. 2009;85(4):269-73.
Bower, C., D'Antoine, H., & Stanley, F. J. (2009). Neural tube defects in Australia: trends in encephaloceles and other neural tube defects before and after promotion of folic acid supplementation and voluntary food fortification. Birth Defects Research. Part A, Clinical and Molecular Teratology, 85(4), 269-73. https://doi.org/10.1002/bdra.20536
Bower C, D'Antoine H, Stanley FJ. Neural Tube Defects in Australia: Trends in Encephaloceles and Other Neural Tube Defects Before and After Promotion of Folic Acid Supplementation and Voluntary Food Fortification. Birth Defects Res Part A Clin Mol Teratol. 2009;85(4):269-73. PubMed PMID: 19180646.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neural tube defects in Australia: trends in encephaloceles and other neural tube defects before and after promotion of folic acid supplementation and voluntary food fortification. AU - Bower,Carol, AU - D'Antoine,Heather, AU - Stanley,Fiona J, PY - 2009/1/31/entrez PY - 2009/1/31/pubmed PY - 2009/7/2/medline SP - 269 EP - 73 JF - Birth defects research. Part A, Clinical and molecular teratology JO - Birth Defects Res. Part A Clin. Mol. Teratol. VL - 85 IS - 4 N2 - BACKGROUND: Use of periconceptional folic acid supplementation has been promoted in Western Australia since late 1992, and voluntary fortification of some foods with folic acid has been permitted in Australia since 1996. Reduced rates of neural tube defects (NTDs) have been observed since 1995. Aboriginal infants have a higher rate of NTDs, but no fall in rates has been documented. Encephaloceles have not been examined separately. METHODS: Data on anencephaly, spina bifida, and encephalocele were obtained from the Western Australian Birth Defects Registry. The prevalence ratio for each type of NTD was calculated, comparing 1993 to 1995 (promotion of supplements, no fortification) and 1996 to 2006 (promotion of supplements and voluntary fortification) with 1980 to 1992 (no promotion or fortification). RESULTS: From 1996 to 2006, there was a 32% reduction in anencephaly, 23% in spina bifida, and 34% in encephalocele compared with 1980 to 1992. There were no differences seen from 1993 to 1995 compared with 1980 to 1992. For Aboriginal infants, the rates were higher than for non-Aboriginal infants, for each type of NTD. The prevalence ratios, comparing 1996 to 2006 with 1980 to 1995, were 0.70 (CI, 0.61-0.79) for non-Aboriginal infants and 0.90 (CI, 0.61-1.32) for Aboriginal infants. CONCLUSIONS: Overall, the rates of encephalocele, anencephaly, and spina bifida have fallen to a similar extent in association with promotion of folic acid supplements and voluntary fortification. No such falls were seen for Aboriginal infants. These data will provide a useful baseline against which to monitor the effects of mandatory fortification on NTDs when it is introduced in Australia in September 2009. SN - 1542-0760 UR - https://www.unboundmedicine.com/medline/citation/19180646/Neural_tube_defects_in_Australia:_trends_in_encephaloceles_and_other_neural_tube_defects_before_and_after_promotion_of_folic_acid_supplementation_and_voluntary_food_fortification_ L2 - https://doi.org/10.1002/bdra.20536 DB - PRIME DP - Unbound Medicine ER -