Original ArticleLong Term Maintenance of Neural Tube Defects Prevention in a High Prevalence State
Section snippets
Methods
Neural tube defects were defined as cases of spina bifida, anencephaly, and encephalocele.1 Midline cranial aplasia cutis congenita and multiple vertebral malformations were included as forme fruste NTDs. Isolated NTDs had no significant anomalies in other organ systems. Hydrocephaly and club feet were considered secondary consequences of NTDs. Abdominal wall defects, diaphragmatic hernia, and holoprosencephaly were considered non-related malformations for purposes of this study.
Both active and
Results
The annual prevalence rates for the 17 years of surveillance are shown in Table I, with a graphic representation of the rates of isolated NTDs, NTDs with other anomalies, and total NTDs for years 1 to 17 (Figure 1). There were statistically significant declines in overall NTDs (P < .0001) and in isolated NTDs (P < .0001), but not for NTDs with associated anomalies (P = .2803) from 1992 through 2009. Table I also shows the rates of spina bifida, anencephaly, and encephalocele for 17 years of
Discussion
A substantial decrease in the prevalence rates of spina bifida, anencephaly, and encephalocele in South Carolina has accompanied the increased consumption of FA by women of childbearing age. Overall, the NTD rate has decreased 58% since 1992, a period during which FA supplement use has increased 4-fold (from 8% to 35% of women of childbearing age). In addition, many breakfast cereals have been fortified with 400 mcg FA per serving, and enriched cereal grain flours have been fortified with 140
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2018, Foods, Nutrients and Food Ingredients with Authorised EU Health ClaimsExposure of methyl mercury in utero and the risk of neural tube defects in a Chinese population
2016, Reproductive ToxicologyCitation Excerpt :Neural tube defects (NTDs) are multifactorial disorders arising from a complex interaction of genetic and environmental factors, and are one of the most common and severe congenital malformations of the central nervous system [1–3]. Although it is well known that taking folic acid during the periconceptional period can greatly reduce a woman’s risk of having a pregnancy affected by an NTD [4], 10 years after folic acid fortification was introduced, NTD rates remain as high as 1 in 1500 births in the United States [5]. Its prevalence is also high in some areas of China (9.4 per 1000 births), although the government began providing folic acid supplements in 2009 to women who live in rural areas and plan to get pregnant [6].
Retrospective Assessment of Cost Savings from Prevention: Folic Acid Fortification and Spina Bifida in the U.S.
2016, American Journal of Preventive MedicineCitation Excerpt :Direct costs excluding caregiver time costs amount to approximately $577,000. Average cost per live-born spina bifida case may have changed with fortification, which was accompanied by increases in the proportion of cases of non-isolated spina bifida29,30 and decreases in the proportion of cases with upper-level (cervical or thoracic) lesions.30,31 Estimates of costs for subtypes of spina bifida, including by lesion level, were not available.
Health-related quality of life compared to life situation and incontinence in adults with myelomeningocele: Is SF-36 a reliable tool?
2013, Journal of Pediatric UrologyCitation Excerpt :Part of this decrease could be explained by an increase in terminated pregnancies as a consequence of prenatal screening, resulting in an incidence of 2.5 terminations per 10,000 pregnancies in 2010 [5]. This decline may also have been a result of increased knowledge about folic acid and its protective effect on neural tube defects [6]. Today the life expectancy of children with a congenital condition, such as MMC, is increasing.
Adults with myelomeningocele: An interview study about life situation and bladder and bowel management
2013, Journal of Pediatric UrologyCitation Excerpt :Part of the decrease could be explained by terminated pregnancies as a consequence of prenatal screening, with an incidence of 2.0 per 10 000 [2]. The decline may also be a result of increased knowledge about folic acid and its protective effect on neural tube defects [3]. Survival rate into adulthood has significantly increased during the last 40 years due to medical innovations such as improved methods for shunting of hydrocephalus and preservation of renal function by use of clean intermittent catheterization (CIC) [4].
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2013, Public Health Nutrition
Supported by the South Carolina Birth Defects Foundation, South Carolina Department of Disabilities and Special Needs, South Carolina Department of Health and Environmental Control, South Carolina Department of Health and Human Services, the Developmental Disabilities Council of the Governor’s Office, South Carolina Chapter of the March of Dimes, Centers for Disease Control and Prevention (U85/CCU 408774, U50/CCU 421871, and U50/CCU 416008 to R.S.), and the National Institute of Mental Health (MH 57840 to R.S.). The authors declare no conflicts of interest.