Document Detail


Spina bifida before and after folic acid fortification in Canada.
MedLine Citation:
PMID:  18655127     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In 1998, fortification of a large variety of cereal products with folic acid became mandatory in Canada. A multicentric study was carried out to assess the impact of this policy on the frequency of NTDs. The present analysis focused on spina bifida. METHODS: The study population included approximately 2 million livebirths, stillbirths, and terminations of pregnancies because of fetal anomalies among women residing in seven Canadian provinces, from 1993 to 2002. Spina bifida cases were divided according to the upper limit of the defect: upper (cranial, cervical, or thoracic) and lower (lumbar or sacral) defects. Based on published results of red blood cell folate tests, the study period was divided into prefortification, partial fortification, and full fortification periods. RESULTS: A total of 1,286 spina bifida cases were identified: 51% livebirths, 3% stillbirths, and 46% terminations. Prevalence decreased from 0.86/1,000 in the prefortification to 0.40 in the full fortification period, while the proportion of upper defects decreased from 32% to 13%. Following fortification, regional variations in the prevalence and distribution of sites almost disappeared. CONCLUSIONS: Results confirmed the etiologic heterogeneity of spina bifida and the more pronounced effect of folic acid in decreasing the risk of the more severe clinical presentations.
Authors:
Philippe De Wals; Fassiatou Tairou; Margot I Van Allen; R Brian Lowry; Jane A Evans; Michiel C Van den Hof; Marian Crowley; Soo-Hong Uh; Pamela Zimmer; Barbara Sibbald; Bridget Fernandez; Nora S Lee; Theophile Niyonsenga
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Birth defects research. Part A, Clinical and molecular teratology     Volume:  82     ISSN:  1542-0760     ISO Abbreviation:  Birth Defects Res. Part A Clin. Mol. Teratol.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-29     Completed Date:  2008-11-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101155107     Medline TA:  Birth Defects Res A Clin Mol Teratol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  622-6     Citation Subset:  IM    
Copyright Information:
(c) 2008 Wiley-Liss, Inc.
Affiliation:
Department of Social and Preventive Medicine, Laval University, Quebec City, QC, Canada. Philippe.Dewals@msp.ulaval.ca
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MeSH Terms
Descriptor/Qualifier:
Canada / epidemiology
Female
Folic Acid / administration & dosage*,  physiology*
Food, Fortified*
Humans
Male
Pregnancy
Prevalence
Retrospective Studies
Spinal Dysraphism / epidemiology*,  metabolism,  prevention & control
Chemical
Reg. No./Substance:
59-30-3/Folic Acid

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


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