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U.S. women of childbearing age who are at possible increased risk of a neural tube defect-affected pregnancy due to suboptimal red blood cell folate concentrations, National Health and Nutrition Examination Survey 2007 to 2012.
Birth Defects Res A Clin Mol Teratol. 2015 Jun; 103(6):517-26.BD

Abstract

BACKGROUND

Red blood cell (RBC) folate concentrations are a potential biomarker of folate-sensitive neural tube defect (NTD) risk in the population. The purpose of this analysis was to describe women in the U.S. population with RBC folate concentrations below those associated with optimal NTD prevention.

METHODS

We used data from the 2007 to 2012 National Health and Nutrition Examination Survey (NHANES) to assess the RBC folate status of U.S. women of childbearing age relative to risk categories for NTD risk based on RBC folate concentrations. We defined suboptimal RBC folate concentrations as those associated with a prevalence of ≥9 NTDs per 10,000 live births.

RESULTS

Among nonpregnant women age 12 to 49 years, 22.8% (95% Confidence Interval: 21.1, 24.6) had suboptimal RBC folate concentrations. Women had greater odds of having a suboptimal RBC folate concentration if they did not use dietary supplements containing folic acid; had mandatorily fortified enriched cereal grain products as their only source of folic acid; were non-Hispanic black or Hispanic; or were current smokers.

CONCLUSION

Based on RBC folate concentrations, we would predict that the majority of U.S. women of reproductive age are not at increased risk for folate sensitive NTDs in the presence of mandatory folic acid fortification. Prevention policies and programs can be aimed at population subgroups identified as having higher predicted risk for folate-sensitive NTDs based on RBC folate concentrations.

Authors+Show Affiliations

National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25884850

Citation

Tinker, Sarah C., et al. "U.S. Women of Childbearing Age Who Are at Possible Increased Risk of a Neural Tube Defect-affected Pregnancy Due to Suboptimal Red Blood Cell Folate Concentrations, National Health and Nutrition Examination Survey 2007 to 2012." Birth Defects Research. Part A, Clinical and Molecular Teratology, vol. 103, no. 6, 2015, pp. 517-26.
Tinker SC, Hamner HC, Qi YP, et al. U.S. women of childbearing age who are at possible increased risk of a neural tube defect-affected pregnancy due to suboptimal red blood cell folate concentrations, National Health and Nutrition Examination Survey 2007 to 2012. Birth Defects Res A Clin Mol Teratol. 2015;103(6):517-26.
Tinker, S. C., Hamner, H. C., Qi, Y. P., & Crider, K. S. (2015). U.S. women of childbearing age who are at possible increased risk of a neural tube defect-affected pregnancy due to suboptimal red blood cell folate concentrations, National Health and Nutrition Examination Survey 2007 to 2012. Birth Defects Research. Part A, Clinical and Molecular Teratology, 103(6), 517-26. https://doi.org/10.1002/bdra.23378
Tinker SC, et al. U.S. Women of Childbearing Age Who Are at Possible Increased Risk of a Neural Tube Defect-affected Pregnancy Due to Suboptimal Red Blood Cell Folate Concentrations, National Health and Nutrition Examination Survey 2007 to 2012. Birth Defects Res A Clin Mol Teratol. 2015;103(6):517-26. PubMed PMID: 25884850.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - U.S. women of childbearing age who are at possible increased risk of a neural tube defect-affected pregnancy due to suboptimal red blood cell folate concentrations, National Health and Nutrition Examination Survey 2007 to 2012. AU - Tinker,Sarah C, AU - Hamner,Heather C, AU - Qi,Yan Ping, AU - Crider,Krista S, Y1 - 2015/04/17/ PY - 2015/03/10/accepted PY - 2015/4/18/entrez PY - 2015/4/18/pubmed PY - 2016/3/18/medline KW - NHANES KW - folic acid KW - fortification KW - neural tube defects KW - optimal RBC folate concentration SP - 517 EP - 26 JF - Birth defects research. Part A, Clinical and molecular teratology JO - Birth Defects Res A Clin Mol Teratol VL - 103 IS - 6 N2 - BACKGROUND: Red blood cell (RBC) folate concentrations are a potential biomarker of folate-sensitive neural tube defect (NTD) risk in the population. The purpose of this analysis was to describe women in the U.S. population with RBC folate concentrations below those associated with optimal NTD prevention. METHODS: We used data from the 2007 to 2012 National Health and Nutrition Examination Survey (NHANES) to assess the RBC folate status of U.S. women of childbearing age relative to risk categories for NTD risk based on RBC folate concentrations. We defined suboptimal RBC folate concentrations as those associated with a prevalence of ≥9 NTDs per 10,000 live births. RESULTS: Among nonpregnant women age 12 to 49 years, 22.8% (95% Confidence Interval: 21.1, 24.6) had suboptimal RBC folate concentrations. Women had greater odds of having a suboptimal RBC folate concentration if they did not use dietary supplements containing folic acid; had mandatorily fortified enriched cereal grain products as their only source of folic acid; were non-Hispanic black or Hispanic; or were current smokers. CONCLUSION: Based on RBC folate concentrations, we would predict that the majority of U.S. women of reproductive age are not at increased risk for folate sensitive NTDs in the presence of mandatory folic acid fortification. Prevention policies and programs can be aimed at population subgroups identified as having higher predicted risk for folate-sensitive NTDs based on RBC folate concentrations. SN - 1542-0760 UR - https://www.unboundmedicine.com/medline/citation/25884850/U_S__women_of_childbearing_age_who_are_at_possible_increased_risk_of_a_neural_tube_defect_affected_pregnancy_due_to_suboptimal_red_blood_cell_folate_concentrations_National_Health_and_Nutrition_Examination_Survey_2007_to_2012_ L2 - https://doi.org/10.1002/bdra.23378 DB - PRIME DP - Unbound Medicine ER -