Folic acid and birth defects: a case study (Iran).

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Medical Genetics

Background:

• Neural tube defects (NTDs) represent a significant category of congenital anomalies.
• Folic acid supplementation is a widely recommended strategy for NTD prevention.
• Understanding regional efficacy is crucial for public health initiatives.

Purpose of the Study:

• To assess the effectiveness of folic acid in preventing NTDs in Northwest Iran.
• To quantify the reduction in NTD prevalence associated with folic acid use.
• To identify other congenital anomalies not associated with folic acid intake.

Main Methods:

• Retrospective analysis of 243 pregnancies with diagnosed congenital anomalies.
• Comparison of NTD prevalence in women with and without folic acid consumption.
• Calculation of Odds Ratios and 95% Confidence Intervals to determine association.

Main Results:

• NTDs were present in 24.7% of pregnancies referred for termination.
• Folic acid use was associated with a 79% reduction in NTDs compared to other anomalies (OR=0.21).
• Folic acid use showed a 94% reduction in NTDs compared to normal pregnancies (OR=0.06).
• No significant association was found between folic acid use and hydrops fetalis, hydrocephaly, Down syndrome, or limb anomalies.

Conclusions:

• Folic acid is highly effective in preventing neural tube defects in the studied population.
• Routine folic acid supplementation should be promoted for all pregnant women.
• Prenatal screening and diagnostic testing remain essential for identifying other fetal abnormalities.