Neural tube defects in Australia: Trends in encephaloceles and other neural tube defects before and after promotion of folic acid supplementation and voluntary food fortification

Bower, Carol; D’Antoine, Heather; Stanley, Fiona

doi:10.1002/bdra.20536

Cited by 79 publications

(68 citation statements)

References 44 publications

(48 reference statements)

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“…18 In Australia where voluntary fortification began in 1995, there has been a 32% reduction in the frequency of anencephaly, a 34% reduction in the frequency of encephalocele, and a 23% reduction in the frequency of spina bifida. 19 In Canada, the level of fortification of flour or cornmeal was 150 g/100 g, and of rice, as high as 308 g/100 g, with a postfortification reduction in NTD frequency of 46%. However, there is marked geographic variation in Canada, and as a result, the magnitude of the decrease was proportional to the prefortification baseline risk in each province, so that geographic differences in risk disappeared postfortification.…”

mentioning

confidence: 99%

Policy statement on folic acid and neural tube defects

Toriello

2011

Genetics in Medicine

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Disclaimer: ACMG standards and guidelines are designed primarily as an educational resource for medical geneticists and other healthcare providers to help them provide quality medical genetic services. Adherence to these standards and guidelines does not necessarily ensure a successful medical outcome. These standards and guidelines should not be considered inclusive of all proper procedures and tests or exclusive of other procedures and tests that are reasonably directed to obtaining the same results. In determining the propriety of any specific procedure or test, the geneticists should apply their own professional judgment to the specific clinical circumstances presented by the individual patient or specimen. It may be prudent, however, to document in the patient's record the rationale for any significant deviation from these standards and guidelines.

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confidence: 99%

Policy statement on folic acid and neural tube defects

Toriello

2011

Genetics in Medicine

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“…A meta-analysis by Lumley et al [17] estimated a 70% reduction in neural tube defects with peri-conceptional supplementation with folic acid. Although the benefits of folic acid had been reported as early as 1980 [17], the use of folic acid supplementation was not popularized until 1992 in Australia [18] and 1996 in Switzerland [19]. This meant that older cohorts (born 1940-1950) from both populations would not have received folic acid supplementation, while some of the younger cohorts (born 1970-1980) would have received folic acid supplementation.…”

Section: Discussionmentioning

confidence: 99%

Confirmation of microevolutionary increase in spina bifida occulta among Swiss birth cohorts

et al. 2010

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Previous studies on the prevalence of spina bifida occulta have indicated a microevolutionary increase in its frequency and possible population differences in the prevalence of the condition. We studied the frequencies of closed and open sacral canals at each sacral level among two birth cohorts in Switzerland. Transverse CT scans and multiplanar reconstruction images of sacra of 95 males and 96 females born in 1940-1950 and 99 males and 94 females born in 1970-1980 in Switzerland were reviewed. We found that individuals born later have significantly more open sacral arches at all sacral levels compared to those born 30-40 years earlier. When results were related to previously published data on Australian cohorts, the trend was the same, but Swiss in both cohorts were less likely to have an open section than Australians at all locations apart from S2. This study confirmed a microevolutionary trend in the opening of sacral canal among two different generations in Switzerland and demonstrated a population difference in the prevalence of spina bifida occulta.

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“…Many pregnancies are unplanned, however, and these women are unlikely to know they are pregnant until after development of the neural tube during the 3 rd and 4 th weeks after conception. Voluntary and mandatory food fortification has therefore been implemented in many countries over the past 15 years to increase folate status in all women of reproductive age, and has further reduced rates of NTDs (Bower et al 2009). Women at high risk of delivering a baby with an NTD, including those whose previous children have had NTDs, are recommended to consume 10-fold higher doses of 4-5 mg/d folic acid periconceptionally (Gomes et al 2016).…”

Section: Evidence For Methyl Donor Abundance As An Asthma and Allergymentioning

confidence: 99%

Pre-birth origins of allergy and asthma

Gatford¹,

Wooldridge

Kind

et al. 2017

Journal of Reproductive Immunology

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Highlights Key points (3-5 dot points, max 85 characters including spaces)  Prenatal exposures alter later disease risk, including for allergy  Epidemiological and experimental evidence suggests IUGR protects against allergy  Elevated methyl donor abundance in late pregnancy may predispose progeny to allergy  Maternal asthma and allergy during pregnancy predispose progeny to allergy Abstract: Allergy is a chronic disease that can develop as early as infancy, suggesting that early life factors are important in its aetiology. Variable associations between size at birth, a crude marker of the fetal environment, and allergy have been reported in humans and require comprehensive review. Associations between birth weight and allergy are however confounded in humans, and we and others have therefore begun exploring the effects of early life events on allergy in experimental models. In particular, we are using ovine models to investigate whether and how a restricted environment before birth protects against allergy, whether methyl donor availability contributes to allergic protection in IUGR, and why maternal asthma during pregnancy is associated with increased risks of allergic disease in children. We found that experimental intrauterine growth restriction (IUGR) in sheep reduced cutaneous responses to antigens in progeny, despite normal or elevated IgE responses. Furthermore, maternal methyl donor supplementation in late pregnancy partially reversed effects of experimental IUGR, consistent with the proposal that epigenetic pathways underlie some but not all effects of IUGR on allergic susceptibility. Ovine experimental allergic asthma with exacerbations reduces relative fetal size in late gestation, with some changes in immune populations in fetal thymus suggestive of increased activation. Maternal allergic asthma in mice also predisposes progeny to allergy development. In conclusion, these findings in experimental models provide direct evidence that a perturbed environment before birth alters immune system development and postnatal function, and provide opportunities to investigate underlying mechanisms and develop and evaluate interventions.

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Neural tube defects in Australia: Trends in encephaloceles and other neural tube defects before and after promotion of folic acid supplementation and voluntary food fortification

Cited by 79 publications

References 44 publications

Policy statement on folic acid and neural tube defects

Policy statement on folic acid and neural tube defects

Confirmation of microevolutionary increase in spina bifida occulta among Swiss birth cohorts

Pre-birth origins of allergy and asthma

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