Folate intake and the primary prevention of non‐neural birth defects

Abstract

Objectives: To investigate whether maternal periconceptional folate intake is associated with a reduction in selected non‐neural birth defects in Western Australia (WA). Methods: Case‐control study of folate intake in women whose infants had orofacial clefts (62); congenital heart defects (151); urinary tract defects (117); limb reduction defects (26); or other major birth defects (119); and 578 control women. Results: Neither folic acid supplements nor dietary folate intake in women not using supplements was significantly associated with a reduction in risk in any of the case groups. In contrast to neural tube defects, WA population data for orofacial clefts, heart defects, limb reduction defects and urinary tract defects showed no fall in prevalence since the introduction of folate promotion and voluntary food fortification. Conclusions: This study provides no evidence of folate being an important factor in the prevention of birth defects other than neural tube defects.

Periconceptional nutrient intakes and risks of conotruncal heart defects

“…However, not observing a reduced risk of these conotruncal heart defects associated with periconceptional folate intake is inconsistent with some earlier studies (14-17), but not all (20-23). The reason for the lack of an association in the current study is unknown.…”

La nutrición en el periodo preconcepcional y los resultados del embarazo: revisión bibliográfica y propuesta de intervención del Dietista-Nutricionista

“…Y por último, en un estudio en China que incluía 358 casos y 422 controles se observó que la suplementación preconcepcional de folatos reducía el riesgo de padecer defectos congénitos del corazón, frente a la suplementación que se había producido en la fase gestacional 25 . En contraposición a todo ello, en otro estudio de caso control realizado en Australia, los autores aseguraban que a excepción de los defectos del tubo neural, no existía una relación entre consumo periconcepcional de ácido fólico y otros defectos en el nacimiento 26 . Esta última afirmación podía no ser significativa frente a las evidencias de otros autores dado que la muestra analizada (449 casos y 578 controles) no incluía el análisis de todos los potenciales defectos congénitos, únicamente: hendiduras oro-faciales (n=62 casos), defectos congénitos del corazón (n=151 casos), defectos del tracto urinario (n=117 casos) y otros defectos (n=119).…”

Fetal and Maternal Physiology and Ultrasound Diagnosis

“…Recent data have confirmed a great impact of maternal diet during pregnancy on fetal growth and development, as well as on postnatal development and health. [34][35][36][37][38][39][40][41][42][43] It is during intrauterine life that the diet has significant effect on the brain development. It has been known for some time that folic acid plays a protective role in neurodevelopmental processes.…”

“…35 Yet, other studies provide no evidence of folate being an important factor in the prevention of birth defects other than neural tube defects. 36 Furthermore, a significant protective effect was seen with large doses of folic acid (approximately 6 mg/d) and iron (150-300 mg/d of ferrous sulfate) during the first gestational month against Down's syndrome. 37 Numerous findings have shown a favorable impact of essential fatty acids on prenatal development.…”