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Reductions in child mortality by preventing spina bifida and anencephaly: Implications in achieving Target 3.2 of the Sustainable Development Goals in developing countries.
Birth Defects Res. 2019 08 15; 111(14):958-966.BD

Abstract

BACKGROUND

There is an opportunity to reduce child mortality by preventing folic acid-preventable spina bifida and anencephaly (FAP SBA) in developing countries. We estimated reductions in FAP SBA-associated child mortality in 69 countries with an immediate potential for mandatory fortification of wheat flour.

METHODS

Using data from multiple sources, we estimated the percent reductions in neonatal, infant, and under-five mortality that would have occurred by preventing FAP SBA; and the contributions of these reductions toward each country's Sustainable Development Goals (SDG) for child mortality reduction. We used the combined prevalence of spina bifida and anencephaly in selected countries before fortification, and estimated preventable child mortality associated with FAP SBA, assuming 0.5 per 1,000 live births as minimum achievable prevalence from mandatory fortification.

RESULTS

Annually, 56,785 live births with FAP SBA occurred in the 69 countries examined. Of these, about 49,680 (87%) would have resulted in deaths under age 5 years, and are preventable through mandatory folic acid fortification. On average, compared to current rates, prevention of FAP SBA would have reduced the neonatal, infant, and under-five mortality by 19% (95% uncertainty interval [UI]: 16-24%), 15% (UI: 13-17%), and 14%, (95% UI: 13-17%), respectively. Prevention of FAP SBA seemed to contribute toward achieving SDG on neonatal and under-five mortality in developing countries.

CONCLUSIONS

Prevention of FAP SBA will lead to notable and immediate reductions in child mortality. Many countries have an opportunity to effectively move toward child mortality-related SDG targets with existing milling infrastructure for food fortification.

Authors+Show Affiliations

Center for Spina Bifida Prevention, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.Center for Spina Bifida Prevention, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30070775

Citation

Kancherla, Vijaya, et al. "Reductions in Child Mortality By Preventing Spina Bifida and Anencephaly: Implications in Achieving Target 3.2 of the Sustainable Development Goals in Developing Countries." Birth Defects Research, vol. 111, no. 14, 2019, pp. 958-966.
Kancherla V, Redpath B, Oakley GP. Reductions in child mortality by preventing spina bifida and anencephaly: Implications in achieving Target 3.2 of the Sustainable Development Goals in developing countries. Birth Defects Res. 2019;111(14):958-966.
Kancherla, V., Redpath, B., & Oakley, G. P. (2019). Reductions in child mortality by preventing spina bifida and anencephaly: Implications in achieving Target 3.2 of the Sustainable Development Goals in developing countries. Birth Defects Research, 111(14), 958-966. https://doi.org/10.1002/bdr2.1362
Kancherla V, Redpath B, Oakley GP. Reductions in Child Mortality By Preventing Spina Bifida and Anencephaly: Implications in Achieving Target 3.2 of the Sustainable Development Goals in Developing Countries. Birth Defects Res. 2019 08 15;111(14):958-966. PubMed PMID: 30070775.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reductions in child mortality by preventing spina bifida and anencephaly: Implications in achieving Target 3.2 of the Sustainable Development Goals in developing countries. AU - Kancherla,Vijaya, AU - Redpath,Ben, AU - Oakley,Godfrey P,Jr Y1 - 2018/08/02/ PY - 2018/03/23/received PY - 2018/05/18/revised PY - 2018/06/01/accepted PY - 2018/8/3/pubmed PY - 2020/6/9/medline PY - 2018/8/3/entrez KW - anencephaly KW - child mortality KW - folic acid KW - fortification KW - mortality KW - spina bifida KW - sustainable development goals SP - 958 EP - 966 JF - Birth defects research JO - Birth Defects Res VL - 111 IS - 14 N2 - BACKGROUND: There is an opportunity to reduce child mortality by preventing folic acid-preventable spina bifida and anencephaly (FAP SBA) in developing countries. We estimated reductions in FAP SBA-associated child mortality in 69 countries with an immediate potential for mandatory fortification of wheat flour. METHODS: Using data from multiple sources, we estimated the percent reductions in neonatal, infant, and under-five mortality that would have occurred by preventing FAP SBA; and the contributions of these reductions toward each country's Sustainable Development Goals (SDG) for child mortality reduction. We used the combined prevalence of spina bifida and anencephaly in selected countries before fortification, and estimated preventable child mortality associated with FAP SBA, assuming 0.5 per 1,000 live births as minimum achievable prevalence from mandatory fortification. RESULTS: Annually, 56,785 live births with FAP SBA occurred in the 69 countries examined. Of these, about 49,680 (87%) would have resulted in deaths under age 5 years, and are preventable through mandatory folic acid fortification. On average, compared to current rates, prevention of FAP SBA would have reduced the neonatal, infant, and under-five mortality by 19% (95% uncertainty interval [UI]: 16-24%), 15% (UI: 13-17%), and 14%, (95% UI: 13-17%), respectively. Prevention of FAP SBA seemed to contribute toward achieving SDG on neonatal and under-five mortality in developing countries. CONCLUSIONS: Prevention of FAP SBA will lead to notable and immediate reductions in child mortality. Many countries have an opportunity to effectively move toward child mortality-related SDG targets with existing milling infrastructure for food fortification. SN - 2472-1727 UR - https://www.unboundmedicine.com/medline/citation/30070775/Reductions_in_child_mortality_by_preventing_spina_bifida_and_anencephaly:_Implications_in_achieving_Target_3_2_of_the_Sustainable_Development_Goals_in_developing_countries_ L2 - https://doi.org/10.1002/bdr2.1362 DB - PRIME DP - Unbound Medicine ER -