Document Detail


Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation.
MedLine Citation:
PMID:  1307234     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The risk of recurrent neural-tube defects is decreased in women who take folic acid or multivitamins containing such during the periconceptional period. The extent to which folic acid supplementation can reduce the first occurrence of defects is not known. METHODS: We conducted a randomized, controlled trial of periconceptional multivitamin supplementation to test the efficacy of this treatment in reducing the incidence of a first occurrence of neural-tube defects. Women planning a pregnancy (in most cases their first) were randomly assigned to receive a single tablet of a vitamin supplement (containing 12 vitamins, including 0.8 mg of folic acid; 4 minerals; and 3 trace elements) or a trace-element supplement (containing copper, manganese, zinc, and a very low dose of vitamin C) daily for at least one month before conception and until the date of the second missed menstrual period or later. RESULTS: Pregnancy was confirmed in 4753 women. The outcome of the pregnancy (whether the fetus or infant had a neural-tube defect or congenital malformation) was known in 2104 women who received the vitamin supplement and in 2052 who received the trace-element supplement. Congenital malformations were significantly more prevalent in the group receiving the trace-element supplement than in the vitamin-supplement group (22.9 per 1000 vs. 13.3 per 1000, P = 0.02). There were six cases of neural-tube defects in the group receiving the trace-element supplement, as compared with none in the vitamin-supplement group (P = 0.029). The prevalence of cleft lip with or without cleft palate was not reduced by periconceptional vitamin supplementation. CONCLUSIONS: Periconceptional vitamin use decreases the incidence of a first occurrence of neural-tube defects.
Authors:
A E Czeizel; I Dud?s
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The New England journal of medicine     Volume:  327     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  1992 Dec 
Date Detail:
Created Date:  1992-12-29     Completed Date:  1992-12-29     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1832-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Human Genetics and Teratology, National Institute of Hygiene, Budapest, Hungary.
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MeSH Terms
Descriptor/Qualifier:
Cleft Lip / prevention & control
Congenital Abnormalities / prevention & control
Female
Folic Acid / administration & dosage
Humans
Neural Tube Defects / prevention & control*
Parity
Preconception Care
Pregnancy
Pregnancy Outcome
Prenatal Care
Trace Elements / administration & dosage
Vitamins / administration & dosage*
Chemical
Reg. No./Substance:
0/Trace Elements; 0/Vitamins; 59-30-3/Folic Acid
Comments/Corrections
Comment In:
N Engl J Med. 1992 Dec 24;327(26):1875-7   [PMID:  1448126 ]
N Engl J Med. 1993 Jun 3;328(22):1642   [PMID:  8487815 ]
N Engl J Med. 1993 Jun 3;328(22):1641-2   [PMID:  8338547 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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