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Neural tube defects: prevalence, etiology and prevention

Atsuo Kondo1, Osamu Kamihira, Hideo Ozawa

  • 1Department of Urology, Tsushima Rehabilitation Hospital, Tsushima, Aichi, Japan. akondo@fj8.so-net.ne.jp

International Journal of Urology : Official Journal of the Japanese Urological Association
|January 6, 2009
PubMed

Insights

Folic acid supplementation significantly prevents neural tube defects like spina bifida. Public health initiatives, including food fortification, are crucial for reducing these birth defects globally.

Area of Science:

  • Public Health
  • Obstetrics & Gynecology
  • Pediatrics

Background:

  • Neural tube defects (NTDs), including spina bifida and anencephaly, impact approximately 300,000 newborns annually worldwide.
  • The efficacy of folic acid in preventing NTDs has been established since 1991.
  • Decreased NTD prevalence is attributed to periconceptional folate supplementation, food fortification, environmental factor avoidance, and improved prenatal screening.

Purpose of the Study:

  • To underscore the critical role of folic acid in preventing neural tube defects.
  • To inform women planning conception about recommended folic acid intake.
  • To highlight public health strategies for NTD reduction.

Main Methods:

  • Review of existing literature on folic acid supplementation and NTD prevention.
  • Analysis of trends in NTD prevalence over the past 20-30 years.
  • Assessment of public health interventions including supplementation and food fortification.

Main Results:

  • Folic acid supplementation is unequivocally effective in preventing NTD occurrence and recurrence.
  • Periconceptional folate intake, food fortification, and prenatal screening have contributed to a global decline in NTDs.
  • A daily intake of 400 micrograms of folic acid is recommended for women planning conception.

Conclusions:

  • Primary prevention of NTDs through periconceptional folic acid intake represents a significant public health opportunity.
  • Continued efforts in food fortification are essential to further reduce NTD incidence.
  • Effective NTD prevention strategies can substantially decrease offspring mortality and morbidity.

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