Folic Acid for the Prevention of Neural Tube Defects

Bortolus, Renata; Parazzini, Fabio; Addis, Antonio

doi:10.1001/jamapediatrics.2017.0857

Cited by 4 publications

(4 citation statements)

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“…In Italy, the official recommendations were launched in April 2004, and the use of folic acid has been free of charge since 2005 under prescription. However, knowledge about the benefits of this vitamin seems to be inadequate among women who planned the pregnancy, as does knowledge about women's access to services for preconception care [17]. Some investigations focus on folic acid supplements during the preconception period.…”

Section: Discussionmentioning

confidence: 99%

Drug Prescriptions during Pregnancy in Lombardy: Temporal Trends and the Impact of the Onset of the COVID-19 Pandemic

Esposito

Cantarutti

Franchi

et al. 2023

Pharmacoepidemiology

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This population-based study aimed at providing an overview of drug prescription patterns during pregnancy in the Italian region of Lombardy from 2010 to 2020. The cohort consisted of 780,075 deliveries identified from the regional healthcare utilization databases. The prevalence of drugs’ dispensed prescriptions was estimated as the proportion of pregnant women with at least one prescription out of the total deliveries over the entire pregnancy and by trimester. Drugs were classified according to the Anatomical Therapeutic Chemical code. In addition, interrupted time series analysis was conducted to investigate temporal trends of antibiotics’ use during the onset of the COVID-19 pandemic. A total of 497,515 women (63.8%) used at least a drug, including vitamins and minerals, at some point during pregnancy. Vitamins, minerals, and anti-anaemic preparations were prescribed in 20.8%, 13.3%, and 18.3% of deliveries over the trimesters of pregnancy. Folic acid was the most prescribed drug, with about one woman out of four, followed by iron preparations, progestogen, and antibiotics (prescription rate, respectively: 15.9%, 10.2%, and 9.8%). A decreasing trend in the dispensing of antibiotics emerged during the entire study period; however, a significant further decrease following the spread of the pandemic was observed. Further evidence is needed to monitor the use of drugs during pregnancy, determinants, and implications.

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Section: Discussionmentioning

confidence: 99%

Drug Prescriptions during Pregnancy in Lombardy: Temporal Trends and the Impact of the Onset of the COVID-19 Pandemic

Esposito

Cantarutti

Franchi

et al. 2023

Pharmacoepidemiology

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“…Considering the role of folate status in the prevention of birth defects and major chronic diseases, diversified intervention strategies should be implemented. Specifically, for women of childbearing age, although the prevalence of preconception folic acid supplementation in Europe has increased after many years of delivered recommendations, a large number of women still do not follow the recommendations and a lot of them start the supplementation too late [50].…”

Section: Discussionmentioning

confidence: 99%

B vitamin blood concentrations and one-carbon metabolism polymorphisms in a sample of Italian women and men attending a unit of transfusion medicine: a cross-sectional study

et al. 2020

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Purpose To define blood status of folate, vitamin B12, vitamin B6, homocysteine, and major one-carbon metabolism-related polymorphisms in healthy, males and females blood donors, aged 18–65 years were evaluated. General characteristics and lifestyle factors were also investigated. Methods An explorative cross-sectional study design was used to evaluate a sample of blood donors attending the Unit of Transfusion Medicine of the Verona University Hospital, Italy. From April 2016 to May 2018, 499 subjects were enrolled (255 men, 244 women of whom 155 of childbearing age). Major clinical characteristics including lifestyle and dietary habits, B vitamins and homocysteine were analyzed. The MTHFR 677 C>T, cSHMT 1420 C>T, DHFR 19 bp ins/del, RFC1 80 G>A polymorphisms were also determined. Results Mean plasma concentrations of folate, vitamin B12, vitamin B6 and homocysteine were 14.2 nmol/L (95% CI 13.7–14.8), 271.9 pmol/L (95% CI 262.6–281.5), 51.0 nmol/L (95% CI 48.7–53.4) and 13.5 µmol/L (95% CI 13.1–14.0), respectively. Plasma folate, was adequate (> 15 nmol/L) in 44.7% of all subjects, 39.0% of males and 42.5% of women < 45 years. Similarly, vitamin B12 was adequate (> 350 pmol/L) in 25.1% of all subjects and in 20.3% of men ≥ 45 years. The rare allele frequencies were 0.21 for MTHFR 677TT, 0.11 for cSHMT 1420TT, 0.18 for DHFR 19 bp del/del, 0.20 for RFC1 80AA, and a gene–nutrient interaction was confirmed for folate concentrations according to MTHFR 677C>T and DHFR 19 bp del/del. Conclusion An Italian sample of healthy blood donors shows that an adequate concentration of plasma folate and vitamin B12 is reached only in a limited percentage of subjects, thus encouraging consideration for specific public health strategies.

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“…One of the most common vitamin deficiencies among childbearing-aged women is folic acid deficiency (1). Folic acid deficiency is a leading cause of neural tube defects (NTDs) such as anencephaly, spina bifida, and encephalocele, which represents a major cause of serious disabilities and mortality among the infant population (2). The onset of NTDs is very early (prenatal), thus, the best medical solution is to prevent it (3).…”

Section: Introductionmentioning

confidence: 99%

“…The onset of NTDs is very early (prenatal), thus, the best medical solution is to prevent it (3). Studies showed that up to 50% of NTDs cases can be prevented by using folic acidcontaining supplements (2). The absorption of folic acid-containing foods, such as broccoli, spinach, and lettuce and some fruits (oranges, bananas) in the body is very low.…”

Section: Introductionmentioning

confidence: 99%

Folic acid deficiency and neural tube defects: the awareness dilemma

Albazee

Almahmoud

2022

JGNS

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One of the most common vitamin deficiencies among childbearing-aged women is folic acid deficiency. Folic acid deficiency is a leading cause of neural tube defects (NTDs) such as anencephaly, spina bifida, and encephalocele, which represents a major cause of serious disabilities and mortality among the infant population. Several studies showed that up to 50% of NTDs cases can be prevented by using folic acid containing supplement. Hence, planned pregnancy and awareness of mother toward this preventable method, plays a crucial role in decreasing NTDs burden. In this mini-review, we explore the prevalence and awareness of folic acid supplementation among childbearing women in different countries around the world, especially in low and middle income countries (LMICs), as well as, reveal the importance of food fortification with folic acid on NTDs burden. The overall awareness about the role of folic acid supplements in prevention of NTDs is low globally, especially in LMICs. Furthermore, compliance of folic acid supplements among childbearing-aged women during periconceptional period is also low. In summary, the findings indicate the importance of improving the awareness level of the importance of folic acid supplementation among women of childbearing age globally, especially in LMICs. It is suggested to promote the advantage of taking folic acid during the ideal time to reduce incidents of NTDs through proper education provided to women by health-care providers. Moreover, LMICs may have food fortification programs, nevertheless, the desirable effects have not achieved due to several limitations. Accordingly, improvement of these programs are required to decrease this dilemma and then to decrease NTDs burden globally, especially in LMICs.

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Folic Acid for the Prevention of Neural Tube Defects

Abstract: With this letter, we wish to encourage a more thorough discussion of important confounders and request more supporting evidence of the day/night outcome comparison to avoid being left in the dark on the causal question.

Cited by 4 publications

References 4 publications

Drug Prescriptions during Pregnancy in Lombardy: Temporal Trends and the Impact of the Onset of the COVID-19 Pandemic

Drug Prescriptions during Pregnancy in Lombardy: Temporal Trends and the Impact of the Onset of the COVID-19 Pandemic

B vitamin blood concentrations and one-carbon metabolism polymorphisms in a sample of Italian women and men attending a unit of transfusion medicine: a cross-sectional study

Folic acid deficiency and neural tube defects: the awareness dilemma

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