Hungarian cohort‐controlled trial of periconceptional multivitamin supplementation shows a reduction in certain congenital abnormalities

Czeizel, Andr̀ew E.; M, Dobó; Vargha, P.

doi:10.1002/bdra.20086

Cited by 213 publications

(197 citation statements)

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“…[7][8][9][10] Moreover, folic-acid supplementation in pregnancy is associated with the decreased incidence of habitual spontaneous abortion and pregnancy complications (e.g., placental abruption and preeclampsia). [4,15] However, folic-acid was taken by less than 50% of women (130, 160 and 120 women in the first, second and third trimester, respectively) in the present study.…”

Section: Discussionmentioning

confidence: 99%

Drug utilization pattern during pregnancy in North India

Sharma¹,

Kapoor²,

Verma³

2006

Indian J Med Sci

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BACKGROUND: Pregnancy is a special physiological condition, where drug treatment presents a special concern. AIMS: To evaluate the drug utilization pattern during pregnancy and to evaluate the effect of the educational and economic status on it.. DESIGN: The retrospective cross-sectional study. SETTING: The postgraduate Department of Pharmacology and Therapeutics of a medical college. and the antenatal clinic of the institution. MATERIALS AND METHODS: Medical students filled 405 questionnaires after interviewing pregnant women (243 primigravida and 152 multigravida). All the collected questionnaires were analysed for various study parameters. STATISTICAL ANALYSIS USED: Inter-group comparison was done using chi-square test. P value <0.05 was considered statistically significant. RESULTS: A total of 700, 1086 and 686 drugs, with an average of 1.73, 2.89 and 2.49 drugs per pregnant women, were used during first, second and third trimester of pregnancy, respectively. A majority of the drugs used, were from category-A, followed by category-B and category-D. However, category C and X drugs constituted 2.90 (20) and 5.71% (40) of drugs used during the third trimester and first trimester, respectively. Herbal/ homeopathic drugs constituted 6.42 (45), 3.68 (40) and 1.46% (10) of the drugs used in the first, second and third trimester of pregnancy, respectively (P=649). 33.33% (135) women believed that drug use during pregnancy is dangerous to both mother and child and 37.03% (150) believed that drugs are dangerous throughout pregnancy. 55.55% (225) females advocated the use of iron/folic acid during pregnancy. 24.69% (100) of women had knowledge about barrier contraceptives. Self-medication and homeopathic/ herbal drugs use was found more in graduates than in undergraduates; as well as, it was more in the higher socioeconomic group than the lower socioeconomic group. CONCLUSION: There is a need to educate and counsel women of child-bearing age, regarding the advantages and disadvantages of drug use during pregnancies, with special reference to alternative therapies and self-medication.

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Section: Discussionmentioning

confidence: 99%

Drug utilization pattern during pregnancy in North India

Sharma¹,

Kapoor²,

Verma³

2006

Indian J Med Sci

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“…Several population-based studies and experiments with animal models have shown that periconceptional multivitamin/folic acid supplementation has a strong protective effect during early stages of embryo development, resulting in a significant reduction in the occurrence of developmental defects, including neural tube defects, CHDs, limb defects, and facial-clefting (Itikala et al, 2001;Botto et al, , 2004Czeizel et al, 2004). Women who take 4 mg folic acid daily from the time of their periconceptional examination until the end of the first trimester of pregnancy have a 40-80% reduced risk of having a baby with neural tube defects (Czeizel and Dudás, 1992;Berry et al, 1999;Huhta et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

A66G and C524T polymorphisms of the methionine synthase reductase gene are associated with congenital heart defects in the Chinese Han population

Zeng¹,

Liu²,

Tong³

et al. 2011

Genet. Mol. Res.

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ABSTRACT. Congenital heart defects (CHDs) are the most common birth defects; genes involved in homocysteine/folate metabolism may play important roles in CHDs. Methionine synthase reductase (MTRR) is one of the key regulatory enzymes involved in the metabolic pathway of homocysteine. We investigated whether two polymorphisms (A66G and C524T) of the MTRR gene are associated with CHDs. A total of 599 children with CHDs and 672 healthy children were included; the polymorphisms were detected by PCR and RFLP analysis. Significant differences in the distributions of A66G and C524T alleles were observed between CHD cases and controls, and slightly increased risks of CHD were associated with 66GG and 524CT genotypes (odds ratios = 1.545 and 1.419, respectively). The genotype frequencies of 524CT in the VSD subgroup, 66GG and 524CT in the PDA subgroup were significantly different from those of controls. In addition, the combined 66AA/524CT, 66AG/524CT and 66GG/524CT in CHDs had odds ratios = 1.589, 1.422 and 1.934, respectively. Increased risks were also observed in 66AA/524CT and 66GG/524CT for ASD, 66AG/524CT for VSD, as well as 66GG/524CT for PDA. In conclusion, MTRR A66G and C524T polymorphisms are associated with increased risk of CHDs.

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“…They concluded that the frequency of NTDs was 2.95/ 1000 newborn babies in Hungary. This investigation had been reconfirmed in 1992, 1994 and 2004 by these authors [8,28,29]. These studies underline the fact, that the reported NTDs from Hungarian National Centre of Epidemiology, Department of Human Genetics and Teratology are representing an insufficient number of NTDs.…”

Section: Discussionmentioning

confidence: 66%

Improper Supplementation Habits of Folic Acid Intake by Hungarian Pregnant Women: Improper Recommendations

Ponyi

Hauser

Müller

et al. 2008

Journal of the American College of Nutrition

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Background: Neural tube defects (NTDs) are some of the most common congenital anomalies. Proper folic acid supplementation is a dominant risk factor, which has been shown to decrease the incidence of NTDs. In Canada, the incidence of neuroblastoma has presented a considerable decrease of 60% as a result of enrichment cereal grain flours with synthetic folic acid. The aim of this study was to investigate the effect of folic acid intake by pregnant women on the incidence of NTDs and neuroblastoma.Methods: Regular folic acid intake has been recommended to pregnant women in Hungary since the eighties of the last century by health visitors eventually raking effect as an official protocol which had been released in 1997. During 2001During , 2002During and 2003, folic acid intake habits of pregnant women were evaluated by health visitors, proving to be successful in collecting data from 95.06% of the pregnant women. The incidence of NTDs has been registered by the Hungarian National Centre of Epidemiology, Department of Human Genetics and Teratology. The Pediatric Cancer Registry provided the incidence of neuroblastoma in children.Results: Consistent findings revealed a regular intake of supplementary folic acid products by 68.71% of the pregnant women. Out of these, 93.13% of pregnant women who were taking folic acid, started the supplementation after their 7 weeks of pregnancies, a time designated as the completion period of the development of the neural tube. The dose of folic acid supplementation was evaluated as less than 5 mg/day in 84.75% of the pregnant women. In Hungary, the incidence of NTDs has remained constant, while the incidence of neuroblastoma has shown constant slight increase in spite of the introduction of folic acid supplementation in 1997.Conclusions: Based on our experience, folic acid supplementation was initiated after the recognition of pregnancy and its application in a dose of lower than 5 mg/day neither decreased the incidence of NTDs nor did it have an effect on the neuroblastoma incidence. It is implicated that proper folic acid supplementation, which is started from the conception, can be achieved only with the enrichment of cereal grain flours.

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Hungarian cohort‐controlled trial of periconceptional multivitamin supplementation shows a reduction in certain congenital abnormalities

Abstract: The results of this cohort-controlled trial support the findings of the previous Hungarian RCT. The primary prevention of some major structural birth defects by multivitamins containing folic acid or by folic acid has great public health importance.

Cited by 213 publications

References 30 publications

Drug utilization pattern during pregnancy in North India

Drug utilization pattern during pregnancy in North India

A66G and C524T polymorphisms of the methionine synthase reductase gene are associated with congenital heart defects in the Chinese Han population

Improper Supplementation Habits of Folic Acid Intake by Hungarian Pregnant Women: Improper Recommendations

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