Folic Acid Supplementation for the Prevention of Neural Tube Defects

Viswanathan, Meera; Treiman, Katherine; Kish-Doto, Julia; Middleton, Jennifer Cook; Coker-Schwimmer, Emmanuel; Nicholson, Wanda K

doi:10.1001/jama.2016.19193

Cited by 137 publications

(100 citation statements)

References 41 publications

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“…Folic acid supplementation before pregnancy and just during postpartum period for at least four weeks helps to protect the occurrence of neural tube defects and other congenital abnormalities [8–11]. And having awareness about preconception folic acid supplementation is very important for women to start taking folic acid early.…”

Section: Discussionmentioning

confidence: 99%

“…According to different interventional studies done in different countries, administering of 0.4 mg of folic acid for the reproductive age group three months before pregnancy, during pregnancy period, and up to one month after pregnancy has been associated with up to 80% reduction in specific congenital anomalies including neural tube defects (NTDs) with associated hydrocephalus, oral facial clefts with or without cleft palate, congenital heart disease, urinary tract anomalies, and limb defects, as well as some pediatric cancers [4–11]. Many articles revealed that preconception folic acid supplementation is associated with increased fetal growth resulting in higher placental and birth weight, and decreased risks of low birth weight and small for gestational age [12–14].…”

Section: Introductionmentioning

confidence: 99%

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Women’s Awareness and Associated Factors on Preconception Folic Acid Supplementation in Adet, Northwestern Ethiopia, 2016: Implication of Reproductive Health

Goshu

Liyeh

Ayele

et al. 2018

Journal of Nutrition and Metabolism

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Introduction Preconception folic acid supplementation is the provision of folate for reproductive age group women who have a plan to be pregnant. According to different studies, in African countries, there is poor utilization of preconception folic supplementation. So this study aimed at assessing women's awareness on preconception care and its associated factors in Adet, Northwestern Ethiopia. Methods A community-based cross-sectional study was conducted from March 1 to April 1, 2016, among 422 reproductive age group women. Systematic random sampling was used to get the study unit, and the data were collected using pretested structured questionnaire via face-to-face interview. The collected data were entered, cleaned, checked using EpiData version 3.1, and finally analyzed using SPSS version 20. Descriptive summary of the data was presented in terms of percentage and frequency. Binary and multiple logistic regressions were used in order to identify predictors using odds ratio at 95% confidence interval. Result In this study, a total of 422 reproductive age group women participated with a response rate of 100%. Of a total of 422 participants, 67 (15.9%) of the women had good awareness on preconception folic acid supplementation. Women's awareness on preconception folic acid supplementation was affected by having a chronic health problem, monthly household income, educational status, and a history of family planning use. Women who were educated (AOR 4.77, CI 1.85–6.98), had a history of family planning use (AOR 3.89, CI 1.77–8.55), had a chronic health problem (AOR 3.47, CI 2.68–5.98), and had a better monthly income (AOR 2.6, CI 2.05–6.76) had good awareness than their counterparts. Conclusion and Recommendation This study concluded that women's awareness on preconception folic acid supplementation was low. This finding suggests that there is a need to give emphasis and deliver health education about preconception folic acid supplementation for women.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Women’s Awareness and Associated Factors on Preconception Folic Acid Supplementation in Adet, Northwestern Ethiopia, 2016: Implication of Reproductive Health

Goshu

Liyeh

Ayele

et al. 2018

Journal of Nutrition and Metabolism

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show abstract

“…2 While in 2000, the FNB has set the RDA for folic acid for pregnant women at 360 mcg and the UL between 480–600 mcg per day, based on a systematic review a recent US Preventive Service Task Force (USPSTF) recommends that all women planning or capable of pregnancy take a daily supplement containing 400 to 800 mcg of folic acid. 23 …”

Section: Discussionmentioning

confidence: 99%

Is Nutrient Content and Other Label Information for Prescription Prenatal Supplements Different from Nonprescription Products?

Saldanha¹,

Dwyer²,

Andrews³

et al. 2017

Journal of the Academy of Nutrition and Dietetics

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Background Prenatal supplements are often recommended to pregnant women to help meet their nutrient needs. Many products are available making it difficult to choose a suitable supplement, as little is known about their labeling and contents to evaluate their appropriateness. Objective To determine differences between prescription and nonprescription prenatal supplements available in the US regarding declared nutrient and non-nutrient ingredients, and the presence of dosing and safety-related information. Design Using two publicly available databases with information about prenatal supplement products, information from prescription and nonprescription product labels were extracted and evaluated. For the 82 prescription and 132 nonprescription products, declared label amounts of seven vitamins and minerals, and docosahexaenoic acid (DHA), the presence of other non-nutrient components, and the presence of key safety and informational elements as identified in two DHHS Office of Inspector General (OIG)’s 2003 reports were compiled and compared. Results Compared with nonprescription products, prescription products contained significantly fewer vitamins (mean ±SE, 9±0.2 vs 11±0.3, P=<.05) and minerals (4±0.1 vs 8±0.3; P=<.05). Declared amounts of folic acid were higher in prescription products, while vitamin A, vitamin D, iodine, and calcium were higher in the nonprescription products. Amounts of iron, zinc, and DHA were similar. Virtually all products contained levels of one or more nutrients that exceeded the RDAs for pregnant and/or lactating women. Product type also affected ingredients added. Fewer prescription products contained botanical ingredients (6% prescription vs. 33% nonprescription) and probiotics (2% prescription vs. 8% nonprescription). Only prescription products contained the stool softener docusate sodium Conclusions Our analysis of prenatal supplements indicates that prescription and nonprescription supplements differ in terms of declared composition and nutrient strength, but have labels that are similarly sparse regarding aspects of usage such as dosing information.

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“…The most common NTDs are spinal cord and spina bifida and anencephaly [8]. Folic acid supplementations for pregnant women are an effective primary care-relevant preventive intervention [9]. America and many other countries issued the regulations to require amending the standards of several grain products and vegetable by folic acid addition [7,10,11].…”

Section: Introductionmentioning

confidence: 99%

“…America and many other countries issued the regulations to require amending the standards of several grain products and vegetable by folic acid addition [7,10,11]. As recommended, all women of childbearing age should take 400 to 800 micrograms folic acid per day during the periconceptional and pregnancy [9,[12][13][14][15][16]. Women who had a fetus diagnosed as affected by a neural tube defect or have given birth to a baby with a neural tube defect have an increased risk and should be administered high-dose supplementation (5 mg folic acid daily) [17].…”

Section: Introductionmentioning

confidence: 99%

Association between Decreased Plasma Folate Levels and MTHFR C677T, and MTRR A66G Gene Polymorphisms as Determinants for Elevated Total Homocysteine Concentrations in Pregnant Women

Song¹,

Song²,

Bao³

et al. 2018

Hereditary Genet Curr Res

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Aims: The aims of this paper were to examine the association between gene polymorphisms of methylenetetrahydrofolate reductase (MTHFR) C677T and methionine synthase reductase (MTRR) A66G with levels of plasma folate and tHcy. Methods:Peripheral venous blood samples were obtained from 143 pregnant women, who had been fasted for more than 10 hours. Plasma tHcy and folate concentrations were measured in plasma specimens. The genotypes for polymorphisms were identified by the PCR-restriction fragment length polymorphism (RFLP). Results:Our results demonstrated that MTHFR 677T allele was the predictors of plasma folate levels in pregnant women. While MTHFR 677TT genotype and MTRR 66G allele were the predictors of plasma tHcy concentrations. Plasma folate levels were negatively correlated with tHcy concentrations (Pearson's correlation coefficient r=-0.358, p=0.000012). With the increase of gestational weeks, the levels of plasma folate was first risen and then fall, whereas, there was a downtrend between gestational weeks and tHcy levels. Conclusion:Plasma folate status and total homocysteine level associated with MTHFR C677T and MTRR A66G gene polymorphisms in pregnant women. According to our study, the pregnant women of homozygous mutation of MTHFR 677TT and/or MTRR 66GG genes generally have lower levels of folate. Therefore, we recommend that pregnant women with 677TT and 66GG genotypes should supplement the appropriate dosage of folic acid based on their genotypes.

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Folic Acid Supplementation for the Prevention of Neural Tube Defects

Cited by 137 publications

References 41 publications

Women’s Awareness and Associated Factors on Preconception Folic Acid Supplementation in Adet, Northwestern Ethiopia, 2016: Implication of Reproductive Health

Women’s Awareness and Associated Factors on Preconception Folic Acid Supplementation in Adet, Northwestern Ethiopia, 2016: Implication of Reproductive Health

Is Nutrient Content and Other Label Information for Prescription Prenatal Supplements Different from Nonprescription Products?

Association between Decreased Plasma Folate Levels and MTHFR C677T, and MTRR A66G Gene Polymorphisms as Determinants for Elevated Total Homocysteine Concentrations in Pregnant Women

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