| Prevention of Neural-Tube Defects with Periconceptional Folic Acid, Methylfolate, or Multivitamins? | |
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MedLine Citation:
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PMID: 21865678 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background/Aims: To review the main results of intervention trials which showed the efficacy of periconceptional folic acid-containing multivitamin and folic acid supplementation in the prevention of neural-tube defects (NTD). Methods and Results: The main findings of 5 intervention trials are known: (i) the efficacy of a multivitamin containing 0.36 mg folic acid in a UK nonrandomized controlled trial resulted in an 83-91% reduction in NTD recurrence, while the results of the Hungarian (ii) randomized controlled trial and (iii) cohort-controlled trial using a multivitamin containing 0.8 mg folic acid showed 93 and 89% reductions in the first occurrence of NTD, respectively. On the other hand, (iv) another multicenter randomized controlled trial proved a 71% efficacy of 4 mg folic acid in the reduction of recurrent NTD, while (v) a public health-oriented Chinese-US trial showed a 41-79% reduction in the first occurrence of NTD depending on the incidence of NTD. Conclusions: Translational application of these findings could result in a breakthrough in the primary prevention of NTD, but so far this is not widely applied in practice. The benefits and drawbacks of 4 main possible uses of periconceptional folic acid/multivitamin supplementation, i.e. (i) dietary intake, (ii) periconceptional supplementation, (iii) flour fortification, and (iv) the recent attempt for the use of combination of oral contraceptives with 6S-5-methytetrahydrofolate (methylfolate), are discussed. Obviously, prevention of NTD is much better than the frequent elective termination of pregnancies after prenatal diagnosis of NTD fetuses. |
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Authors:
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Andrew E Czeizel; István Dudás; László Paput; Ferenc Bánhidy |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-8-25 |
Journal Detail:
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Title: Annals of nutrition & metabolism Volume: 58 ISSN: 1421-9697 ISO Abbreviation: - Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-8-25 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8105511 Medline TA: Ann Nutr Metab Country: - |
Other Details:
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Languages: ENG Pagination: 263-271 Citation Subset: - |
Copyright Information:
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Copyright © 2011 S. Karger AG, Basel. |
Affiliation:
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Foundation for the Community Control of Hereditary Diseases, Budapest, Hungary. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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