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Folic acid and neural tube defects: Discovery, debate and the need for policy change
Neural tube defects (NTDs) are a group of relatively common fatal or severely disabling birth defects that result in about 300,000 cases a year world-wide. The search for a cause was elusive, but in 1991 it was shown that about 8 out of 10 cases are due to a lack of vitamin B9 (folate) and are there...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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SAGE Publications
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9381685/ https://www.ncbi.nlm.nih.gov/pubmed/35735352 http://dx.doi.org/10.1177/09691413221102321 |
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author | Wald, Nicholas J |
author_facet | Wald, Nicholas J |
author_sort | Wald, Nicholas J |
collection | PubMed |
description | Neural tube defects (NTDs) are a group of relatively common fatal or severely disabling birth defects that result in about 300,000 cases a year world-wide. The search for a cause was elusive, but in 1991 it was shown that about 8 out of 10 cases are due to a lack of vitamin B9 (folate) and are therefore preventable. This article (i) describes the challenge in finding the cause; (ii) examines the reasons for the failure of many countries to introduce folic acid fortification of staple foods such as flour and rice; (iii) shows that countries that have introduced fortification failed to do so in a fully effective way; (iv) shows how current preventive polices are confusing, inconsistent and sub-optimal; (v) shows that the proposed UK folic acid fortification policy is expected to prevent about 1 out of 10 NTD cases only; and (vi) proposes a simple, fully effective fortification policy that would prevent about 8 out of 10 NTDs and avoid the need for women to start taking folic acid supplements before pregnancy, a policy that has been shown to fail because only a small percentage of women adopt this practice. |
format | Online Article Text |
id | pubmed-9381685 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-93816852022-08-18 Folic acid and neural tube defects: Discovery, debate and the need for policy change Wald, Nicholas J J Med Screen Special Article Neural tube defects (NTDs) are a group of relatively common fatal or severely disabling birth defects that result in about 300,000 cases a year world-wide. The search for a cause was elusive, but in 1991 it was shown that about 8 out of 10 cases are due to a lack of vitamin B9 (folate) and are therefore preventable. This article (i) describes the challenge in finding the cause; (ii) examines the reasons for the failure of many countries to introduce folic acid fortification of staple foods such as flour and rice; (iii) shows that countries that have introduced fortification failed to do so in a fully effective way; (iv) shows how current preventive polices are confusing, inconsistent and sub-optimal; (v) shows that the proposed UK folic acid fortification policy is expected to prevent about 1 out of 10 NTD cases only; and (vi) proposes a simple, fully effective fortification policy that would prevent about 8 out of 10 NTDs and avoid the need for women to start taking folic acid supplements before pregnancy, a policy that has been shown to fail because only a small percentage of women adopt this practice. SAGE Publications 2022-06-23 2022-09 /pmc/articles/PMC9381685/ /pubmed/35735352 http://dx.doi.org/10.1177/09691413221102321 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Special Article Wald, Nicholas J Folic acid and neural tube defects: Discovery, debate and the need for policy change |
title | Folic acid and neural tube defects: Discovery, debate and the need for policy change |
title_full | Folic acid and neural tube defects: Discovery, debate and the need for policy change |
title_fullStr | Folic acid and neural tube defects: Discovery, debate and the need for policy change |
title_full_unstemmed | Folic acid and neural tube defects: Discovery, debate and the need for policy change |
title_short | Folic acid and neural tube defects: Discovery, debate and the need for policy change |
title_sort | folic acid and neural tube defects: discovery, debate and the need for policy change |
topic | Special Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9381685/ https://www.ncbi.nlm.nih.gov/pubmed/35735352 http://dx.doi.org/10.1177/09691413221102321 |
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