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The primary prevention of birth defects: Multivitamins or folic acid?

Periconceptional use of folic acid alone or in multivitamin supplements is effective for the primary prevention of neural-tube defects. The Hungarian randomized and two-cohort controlled trials showed that periconceptional multivitamin supplementation can reduce the occurrence of some other structur...

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Autor principal: Czeizel, Andrew E.
Formato: Texto
Lenguaje:English
Publicado: Ivyspring International Publisher 2004
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1074510/
https://www.ncbi.nlm.nih.gov/pubmed/15912190
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author Czeizel, Andrew E.
author_facet Czeizel, Andrew E.
author_sort Czeizel, Andrew E.
collection PubMed
description Periconceptional use of folic acid alone or in multivitamin supplements is effective for the primary prevention of neural-tube defects. The Hungarian randomized and two-cohort controlled trials showed that periconceptional multivitamin supplementation can reduce the occurrence of some other structural birth defects, i.e. congenital abnormalities. These findings were supported by many, but not all observational studies. Recently there have been two main debated questions. The first one is whether the use of folic acid alone or folic acid-containing multivitamins is better. The second one is connected with the dilemma of whether high dose of folic acid (e.g. 5 mg) might be better than a daily multivitamin with 0.4 – 0.8 mg of folic acid. Comparison of the pooled data of two Hungarian trials using a multivitamin containing 0.8 mg folic acid and the data of the Hungarian Case-Control Surveillance of Congenital Abnormalities using high dose of folic acid seemed to be appropriate to answer these questions. Multivitamins containing 0.4 – 0.8 mg of folic acid were more effective for the reduction of neural-tube defects than high dose of folic acid. Both multivitamins and folic acid can prevent some part of congenital cardiovascular malformations. Only multivitamins were able to reduce the prevalence at birth of obstructive defects of urinary tract, limb deficiencies and congenital pyloric stenosis. However, folic acid was effective in preventing some part of rectal/anal stenosis/atresia, and high dose of folic acid had effect in preventing some orofacial clefts. The findings are consistent that periconceptional multivitamin and folic acid supplementation reduce the overall occurrence of congenital abnormalities in addition to the demonstrated effect on neural-tube defects.
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spelling pubmed-10745102005-05-18 The primary prevention of birth defects: Multivitamins or folic acid? Czeizel, Andrew E. Int J Med Sci Research Paper Periconceptional use of folic acid alone or in multivitamin supplements is effective for the primary prevention of neural-tube defects. The Hungarian randomized and two-cohort controlled trials showed that periconceptional multivitamin supplementation can reduce the occurrence of some other structural birth defects, i.e. congenital abnormalities. These findings were supported by many, but not all observational studies. Recently there have been two main debated questions. The first one is whether the use of folic acid alone or folic acid-containing multivitamins is better. The second one is connected with the dilemma of whether high dose of folic acid (e.g. 5 mg) might be better than a daily multivitamin with 0.4 – 0.8 mg of folic acid. Comparison of the pooled data of two Hungarian trials using a multivitamin containing 0.8 mg folic acid and the data of the Hungarian Case-Control Surveillance of Congenital Abnormalities using high dose of folic acid seemed to be appropriate to answer these questions. Multivitamins containing 0.4 – 0.8 mg of folic acid were more effective for the reduction of neural-tube defects than high dose of folic acid. Both multivitamins and folic acid can prevent some part of congenital cardiovascular malformations. Only multivitamins were able to reduce the prevalence at birth of obstructive defects of urinary tract, limb deficiencies and congenital pyloric stenosis. However, folic acid was effective in preventing some part of rectal/anal stenosis/atresia, and high dose of folic acid had effect in preventing some orofacial clefts. The findings are consistent that periconceptional multivitamin and folic acid supplementation reduce the overall occurrence of congenital abnormalities in addition to the demonstrated effect on neural-tube defects. Ivyspring International Publisher 2004-03-20 /pmc/articles/PMC1074510/ /pubmed/15912190 Text en © Ivyspring International Publisher. This is an open access article. Distribution or copying is permitted, provided that the article is in whole, unmodified, and properly cited.
spellingShingle Research Paper
Czeizel, Andrew E.
The primary prevention of birth defects: Multivitamins or folic acid?
title The primary prevention of birth defects: Multivitamins or folic acid?
title_full The primary prevention of birth defects: Multivitamins or folic acid?
title_fullStr The primary prevention of birth defects: Multivitamins or folic acid?
title_full_unstemmed The primary prevention of birth defects: Multivitamins or folic acid?
title_short The primary prevention of birth defects: Multivitamins or folic acid?
title_sort primary prevention of birth defects: multivitamins or folic acid?
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1074510/
https://www.ncbi.nlm.nih.gov/pubmed/15912190
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