Document Detail

Decline in the prevalence of spina bifida and anencephaly by race/ethnicity: 1995-2002.
MedLine Citation:
PMID:  16140696     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: In an effort to reduce the occurrence of neural tube defects (NTDs), folic acid fortification of US enriched grain products was authorized by the Food and Drug Administration in March 1996 and required by January 1998. Fortification has been shown to result in an important decline in the prevalence of spina bifida and anencephaly in the general US population; however, fortification's impact on specific racial/ethnic groups has not been well described. We sought to characterize the decline in the prevalence of spina bifida and anencephaly among specific racial/ethnic groups during the transition to mandatory folic acid fortification in the United States. METHODS: Data from 21 population-based birth defects surveillance systems were used to examine trends in prevalence of spina bifida and anencephaly for specific racial/ethnic groups for the years 1995-2002. These years were divided into 3 periods: prefortification, optional fortification, and mandatory fortification. Race/ethnicity was defined as Hispanic, non-Hispanic white, and non-Hispanic black. Prevalence ratios were calculated for each racial/ethnic group by dividing the prevalence from the mandatory fortification period by the prevalence in the prefortification period. RESULTS: The study included data on 4468 cases of spina bifida and 2625 cases of anencephaly. The prevalence of spina bifida and anencephaly was highest among Hispanic births, followed by non-Hispanic white births, with the lowest prevalence among non-Hispanic black births. Significant declines in spina bifida and anencephaly were observed among Hispanic births and non-Hispanic white births. The prevalence ratio for non-Hispanic black births was of borderline significance for spina bifida and was not significant for anencephaly. CONCLUSIONS: The results of this study suggest that folic acid fortification is associated with significant decreases in the prevalence of spina bifida and anencephaly among non-Hispanic white and Hispanic births. The magnitude of the reduction was similar between these 2 groups and was more pronounced for spina bifida than for anencephaly. The decline in the prevalence of spina bifida and anencephaly among non-Hispanic black births did not reach statistical significance. Efforts to increase folic acid consumption for the prevention of NTDs in pregnancies among women of all races/ethnicities should be continued, and studies to identify and elucidate other risk factors for NTDs are warranted.
Laura J Williams; Sonja A Rasmussen; Alina Flores; Russell S Kirby; Larry D Edmonds
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatrics     Volume:  116     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-09-05     Completed Date:  2005-12-13     Revised Date:  2006-05-10    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  580-6     Citation Subset:  AIM; IM    
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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MeSH Terms
African Continental Ancestry Group / statistics & numerical data
Anencephaly / epidemiology,  ethnology*
Continental Population Groups / statistics & numerical data*
Ethnic Groups / statistics & numerical data*
European Continental Ancestry Group / statistics & numerical data
Folic Acid / administration & dosage
Food, Fortified
Hispanic Americans / statistics & numerical data
Prenatal Care
Puerto Rico / epidemiology
Spinal Dysraphism / epidemiology,  ethnology*
United States / epidemiology
Reg. No./Substance:
59-30-3/Folic Acid
Comment In:
Pediatrics. 2005 Sep;116(3):753-5   [PMID:  16140718 ]
Pediatrics. 2006 Apr;117(4):1394-9   [PMID:  16585338 ]

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