Measuring Prevalence: Trends in neural tube defects in Western Australia

Abstract

Objective: To repor t on trends in neural tube defects in Wester n Australia, in relation to folate promotion, periconceptional use of folic acid supplements and food fortification with folate.

Prevalence of neural tube defects in Australia prior to mandatory fortification of bread‐making flour with folic acid

“…[6][7][8] Prior to this, the total prevalence of NTDs in Australia was approximately 20/10,000 births. [9][10][11] A decline in the rate has been seen since these initiatives were instituted, [11][12][13] although this decline has not been seen among the Aboriginal and Torres Strait Islanders. 14 With the aim of reducing the prevalence of NTDs, in June 2007, the Australian Food Regulatory Ministerial Council agreed to mandatory fortification of bread-making flour with folic acid.…”

Cost-effectiveness of mandatory folate fortification v. other options for the prevention of neural tube defects: results from Australia and New Zealand

“…When mandatory fortification was introduced in the USA, mean total dietary folate intake (includes food folate and folic acid from fortification) was generally to be reported low, estimated at 275 mg/d (41) . This compares with the recent situation in Australia (and New Zealand) with estimated intake of 338 mg/d (composed of 230 mg/d from natural sources (12,13) and an additional 108 mg/d from fortified food (10,11) ). This reflects a successful voluntary fortification policy in Australia and New Zealand.…”

“…In 1999, more than 100 folate-fortified foods (predominantly breakfast cereals, fruit juices and breads) were reported to be available in Australia (with fewer in New Zealand). It was estimated that in 2006 mean folic acid intake for women aged 16-44 years from fortified foods was 108 mg/d in Australia and 62 mg/d in New Zealand (10,11) . Data from one Australian study analysing data for the states with adequate quality data (South Australia, Western Australia and Victoria) indicated a drop in NTD of 10-30 % since the introduction of voluntary folic acid fortification, although precise impacts are difficult to ascertain (3) .…”

Strategies for Prevention of Neural Tube Defects

“…The proportion of women taking periconceptional folic acid supplements increased from 13% to 30% over the same period (Bower et al, 1997). Since the introduction of this promotion, the prevalence of NTDs in Western Australia, which was about two per 1,000 births from 1980 until 1995, fell by 30% in 1996 (Bower et al, 2002). The estimated increase in mean serum folate concentration was 19% after educational campaigns to increase periconceptional folic acid use (Metz et al, 2002).…”