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Prevention of congenital abnormalities by periconceptional multivitamin supplementation
1Department of Human Genetics and Teratology, National Institute of Hygiene-WHO Collaborating Centre for the Community Control of Hereditary Diseases, Budapest, Hungary.
Insights
Periconceptional multivitamin supplementation significantly reduced neural tube defects and other major congenital abnormalities. This finding highlights the importance of prenatal vitamins for preventing birth defects.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Genetics
Background:
- Congenital abnormalities pose a significant public health challenge.
- Neural tube defects are a major concern in early pregnancy.
- Periconceptional supplementation is a key area of research in prenatal care.
Purpose of the Study:
- To evaluate the impact of periconceptional multivitamin supplementation on neural tube defects.
- To investigate the effect of multivitamins on other congenital abnormalities.
Main Methods:
- A randomized controlled trial was conducted within the Hungarian family planning program.
- Participants received daily multivitamin or trace element supplements for at least one month before conception and two months after.
- Outcomes included major and mild congenital abnormalities in 4156 pregnancies and 3713 infants.
Main Results:
- Multivitamin supplementation significantly lowered the rate of all major congenital abnormalities compared to trace elements.
- A notable reduction in neural tube defects was observed.
- The rate of major congenital abnormalities, excluding neural tube defects and genetic syndromes, was significantly lower in the multivitamin group.
Conclusions:
- Periconceptional multivitamin intake reduces the incidence of neural tube defects.
- Multivitamin supplementation also decreases the occurrence of other major non-genetic congenital abnormalities.
- Further research is recommended to distinguish between chance and vitamin-dependent effects.
Objective:
To study the effect of periconceptional multivitamin supplementation on neural tube defects and other congenital abnormality entities.
Design:
Randomised controlled trial of supplementation with multivitamins and trace elements.
Setting:
Hungarian family planning programme.
Subjects:
4156 pregnancies with known outcome and 3713 infants evaluated in the eighth month of life.
Interventions:
A single tablet of a multivitamin including 0.8 mg of folic acid or trace elements supplement daily for at least one month before conception and at least two months after conception.
Main Outcome Measures:
Number of major and mild congenital abnormalities.
Results:
The rate of all major congenital abnormalities was significantly lower in the group given vitamins than in the group given trace elements and this difference cannot be explained totally by the significant reduction of neural tube defects. The rate of major congenital abnormalities other than neural tube defects and genetic syndromes was 9.0/1000 in pregnancies with known outcome in the vitamin group and 16.6/1000 in the trace element group; relative risk 1.85 (95% confidence interval 1.02 to 3.38); difference, 7.6/1000. The rate of all major congenital abnormalities other than neural tube defects and genetic syndromes diagnosed up to the eighth month of life was 14.7/1000 informative pregnancies in the vitamin group and 28.3/1000 in the trace element group; relative risk 1.95 (1.23 to 3.09); difference, 13.6/1000. The rate of some congenital abnormalities was lower in the vitamin group than in the trace element group but the differences for each group of abnormalities were not significant.
Conclusions:
Periconceptional multivitamin supplementation can reduce not only the rate of neural tube defects but also the rate of other major non-genetic syndromatic congenital abnormalities. Further studies are needed to differentiate the chance effect and vitamin dependent effect.