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A 2017 global update on folic acid-preventable spina bifida and anencephaly.
Birth Defects Res. 2018 08 15; 110(14):1139-1147.BD

Abstract

BACKGROUND

Spina bifida and anencephaly are largely preventable birth defects through mandatory folic acid fortification. Our objective was to estimate the proportion of folic acid-preventable spina bifida and anencephaly (FAP SBA) prevented worldwide through mandatory fortification of wheat and/or maize flour with folic acid during the year 2017.

METHODS

Using existing data, we identified countries with mandatory fortification policies that added at least 1.0 ppm folic acid to wheat and/or maize flour and had information on percentage of industrially milled flour that is fortified. We assumed mandatory folic acid fortification at 200 μg/day of folic acid fully protects against FAP SBA, reducing the prevalence of spina bifida and anencephaly to 0.5 per 1,000 live births.

RESULTS

Overall, 59 countries met our criteria for implementing mandatory folic acid fortification of wheat and/or maize flour in 2017. These countries prevented about 50,270 out of 280,500 FAP SBA births in 2017. Thus, we have only achieved 18% prevention of FAP SBA worldwide. Several countries in Africa and Asia with a high number of FAP SBA-affected births do not have mandatory fortification.

CONCLUSION

About 230,000 children unnecessarily developed FAP SBA globally in 2017. There is an urgent need for all countries to implement mandatory folic acid fortification, a proven, safe public health intervention that saves money and prevents infant mortality and disability. Prevention of FAP SBA can play an important role in helping countries to achieve their Sustainable Development Goals for health.

Authors+Show Affiliations

Center for Spina Bifida Prevention, Department of Epidemiology, Rollins School of Public Health of Emory University, Atlanta, Georgia.Hubert Department of Global Health, Rollins School of Public Health of Emory University, Atlanta, Georgia.Food Fortification Initiative, Atlanta, Georgia.Center for Spina Bifida Prevention, Department of Epidemiology, Rollins School of Public Health of Emory University, Atlanta, Georgia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30070772

Citation

Kancherla, Vijaya, et al. "A 2017 Global Update On Folic Acid-preventable Spina Bifida and Anencephaly." Birth Defects Research, vol. 110, no. 14, 2018, pp. 1139-1147.
Kancherla V, Wagh K, Johnson Q, et al. A 2017 global update on folic acid-preventable spina bifida and anencephaly. Birth Defects Res. 2018;110(14):1139-1147.
Kancherla, V., Wagh, K., Johnson, Q., & Oakley, G. P. (2018). A 2017 global update on folic acid-preventable spina bifida and anencephaly. Birth Defects Research, 110(14), 1139-1147. https://doi.org/10.1002/bdr2.1366
Kancherla V, et al. A 2017 Global Update On Folic Acid-preventable Spina Bifida and Anencephaly. Birth Defects Res. 2018 08 15;110(14):1139-1147. PubMed PMID: 30070772.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A 2017 global update on folic acid-preventable spina bifida and anencephaly. AU - Kancherla,Vijaya, AU - Wagh,Kaustubh, AU - Johnson,Quentin, AU - Oakley,Godfrey P,Jr Y1 - 2018/08/02/ PY - 2018/04/07/received PY - 2018/06/14/accepted PY - 2018/8/3/pubmed PY - 2019/6/18/medline PY - 2018/8/3/entrez KW - anencephaly KW - epidemiology KW - flour fortification KW - folic acid KW - prevention KW - spina bifida SP - 1139 EP - 1147 JF - Birth defects research JO - Birth Defects Res VL - 110 IS - 14 N2 - BACKGROUND: Spina bifida and anencephaly are largely preventable birth defects through mandatory folic acid fortification. Our objective was to estimate the proportion of folic acid-preventable spina bifida and anencephaly (FAP SBA) prevented worldwide through mandatory fortification of wheat and/or maize flour with folic acid during the year 2017. METHODS: Using existing data, we identified countries with mandatory fortification policies that added at least 1.0 ppm folic acid to wheat and/or maize flour and had information on percentage of industrially milled flour that is fortified. We assumed mandatory folic acid fortification at 200 μg/day of folic acid fully protects against FAP SBA, reducing the prevalence of spina bifida and anencephaly to 0.5 per 1,000 live births. RESULTS: Overall, 59 countries met our criteria for implementing mandatory folic acid fortification of wheat and/or maize flour in 2017. These countries prevented about 50,270 out of 280,500 FAP SBA births in 2017. Thus, we have only achieved 18% prevention of FAP SBA worldwide. Several countries in Africa and Asia with a high number of FAP SBA-affected births do not have mandatory fortification. CONCLUSION: About 230,000 children unnecessarily developed FAP SBA globally in 2017. There is an urgent need for all countries to implement mandatory folic acid fortification, a proven, safe public health intervention that saves money and prevents infant mortality and disability. Prevention of FAP SBA can play an important role in helping countries to achieve their Sustainable Development Goals for health. SN - 2472-1727 UR - https://www.unboundmedicine.com/medline/citation/30070772/A_2017_global_update_on_folic_acid_preventable_spina_bifida_and_anencephaly_ L2 - https://doi.org/10.1002/bdr2.1366 DB - PRIME DP - Unbound Medicine ER -