[Spina bifida: prevention policy can be more effective]

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Medical Genetics

Background:

• Spina bifida, a severe neural tube defect, shows decreasing but still unacceptably high prevalence.
• Current folic acid supplementation compliance among women planning pregnancy is only one-third, though increasing.
• Folic acid supplementation alone cannot completely prevent spina bifida.

Purpose of the Study:

• To highlight the need for intensified folic acid use campaigns.
• To explore additional prevention strategies for spina bifida.
• To investigate the potential of second-trimester ultrasound screening for secondary prevention.

Main Methods:

• Review of current spina bifida prevalence data.
• Analysis of folic acid compliance rates.
• Discussion of ultrasound screening as a secondary prevention method.

Main Results:

• Despite efforts, spina bifida rates remain a significant public health concern.
• Folic acid use is increasing but insufficient for complete prevention.
• Ultrasound screening in the second trimester presents a potential avenue for further reduction.

Conclusions:

• Intensified folic acid campaigns are crucial but insufficient on their own.
• Second-trimester ultrasound screening should be urgently studied for its role in secondary spina bifida prevention.
• A combined approach of primary and secondary prevention may be necessary to further reduce spina bifida incidence.