This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Brent, R. L.
Right arrow Articles by Mattison, D. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Brent, R. L.
Right arrow Articles by Mattison, D. R.
Related Collections
Right arrow Premature & Newborn

PEDIATRICS Vol. 106 No. 4 October 2000, pp. 825-827

COMMENTARY:
The Unnecessary Epidemic of Folic Acid-Preventable Spina Bifida and Anencephaly

The first 300 words of the full text of this article appear below.

With great determination and creativity, Stevenson and colleagues1 launched a statewide program to prevent folic acid-preventable spina bifida and anencephaly---2 of the most common and severe birth defects. Their work is a model of what should occur in every state in the country. They implemented three related activities---statewide, comprehensive neural tube defect (NTD) surveillance, a folic acid supplementation program for high-risk women who have had a NTD-affected pregnancy, and a statewide folic acid education campaign for all women of reproductive age. From their report in this issue of Pediatrics, we can see how well they did.

Surveillance was a success. From October 1992 through September 1998, they identified 360 NTD births among 278 122 births. They monitored the secular trend and saw a decrease from near 2 per thousand to near 1 per thousand. They found that 82% of the NTD were isolated. They found that 4 cases of spina bifida were associated with valproic acid exposure during pregnancy. They identified the increased risk for NTDs in women with insulin-dependent diabetes mellitus. Women with insulin-dependent diabetes produced 9 NTDs or 2.5% of the cases, while these women have only about .5% of the births. Thus, the South Carolina group has shown not only that a good surveillance system can provide trend data, but that it can also identify subgroups of women needing special attention if we are to prevent their infant's birth defects. There is the need for more work to determine how to reduce the NTD risk for women with epilepsy and for women with insulin-dependent diabetes mellitus.

The folic acid program for women with a high-risk for NTDs was a success. One hundred eight women who had had infants with isolated NTDs had 132 subsequent pregnancies. Folic acid was used appropriately in 85.6% (113/132) of those pregnancies and there were no NTD pregnancies among . . . [Full Text of this Article]


This article has been cited by other articles:


Home page
 PediatricsHome page
R. L. Brent and G. P. Oakley Jr
Further Efforts to Reduce the Incidence of Neural Tube Defects
Pediatrics, January 1, 2007; 119(1): 225 - 226.
[Full Text] [PDF]

Home page
 PediatricsHome page
R. L. Brent and G. P. Oakley Jr
The Folate Debate
Pediatrics, April 1, 2006; 117(4): 1418 - 1419.
[Full Text] [PDF]

Home page
 PediatricsHome page
R. L. Brent and G. P. Oakley Jr
The Folic Acid Debate Continues: In Reply
Pediatrics, April 1, 2006; 117(4): 1460 - 1460.
[Full Text] [PDF]

Home page
 PediatricsHome page
R. L. Brent and G. P. Oakley Jr
Triumph and/or Tragedy: The Present Food and Drug Administration Program of Enriching Grains With Folic Acid
Pediatrics, March 1, 2006; 117(3): 930 - 932.
[Full Text] [PDF]

Home page
 PediatricsHome page
R. L. Brent and G. P. Oakley Jr
The Food and Drug Administration Must Require the Addition of More Folic Acid in "Enriched" Flour and Other Grains
Pediatrics, September 1, 2005; 116(3): 753 - 755.
[Full Text] [PDF]

Home page
 CMAJHome page
V. L. Persad, M. C. Van den Hof, J. M. Dube, and P. Zimmer
Incidence of open neural tube defects in Nova Scotia after folic acid fortification
Can. Med. Assoc. J., August 1, 2002; 167(3): 241 - 245.
[Abstract] [Full Text] [PDF]

Home page
 J Child NeurolHome page
K. R. Holden, J. S. Collins, J. F. Greene, S. Hinkle, A. F. Nave, J. M. Portillo, G. P. Page, and R. E. Stevenson
Dietary Intake and Blood Folate Levels in Honduran Women of Childbearing Age
J Child Neurol, May 1, 2002; 17(5): 341 - 345.
[Abstract] [PDF]

Home page
 Obstet GynecolHome page
M. I. Evans, E. Llurba, E. J. Landsberger, J. E. O'Brien, and H. H. Harrison
Impact of Folic Acid Fortification in the United States: Markedly Diminished High Maternal Serum Alpha-Fetoprotein Values
Obstet. Gynecol., January 1, 2002; 103(3): 474 - 479.
[Abstract] [Full Text]

Home page
 PediatricsHome page
R. K. Campbell;, R. L. Brent, G. P. Oakley Jr, and D. R. Mattison
The Unnecessary Epidemic of Folic Acid-Preventable Spina Bifida and Anencephaly
Pediatrics, October 1, 2001; 108(4): 1048 - 1050.
[Full Text] [PDF]