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- W3094521167 abstract "Many pediatricians assume that neural tube defects (NTDs) are disorders of past times, prior to the introduction of prenatal vitamins in the 1970s and 1980s and then fortification of cereal grain products with folic acid in the late 1990s. However, in this volume of The Journal, Dean et al show that such thinking is simply wrong. The investigators examined the incidence of NTDs—spina bifida, anencephaly, and encephalocele—with and without other associated anomalies in South Carolina over 6 years before fortification and during 20 years with fortification (Figure). Total NTDs (black boxes) declined from 1/769 livebirths and fetal deaths to 1/1242, while isolated NTDs (clear boxes) during fortification years continued on average to comprise 74% of all NTDs compared with 26% of NTDs associated with other birth defects (stippled boxes). Isolated NTDS are considered to be less likely due to chromosomal aberrations or known teratogens. From this study, we should note that the overall prevalence of NTDs, particularly isolated, is still notably high compared with other severe pediatric disorders. Perhaps we have reached the limits of folic acid supplementation to prevent NTDs. As the authors note, failure to consider other causes of NTDs and then act with additional measures is akin to stating tacitly that the continued occurrence of isolated NTDs is acceptable. More work is clearly needed. Article page 186 ▸ Neural Tube Defects and Associated Anomalies before and after Folic Acid FortificationThe Journal of PediatricsVol. 226PreviewTo examine the prevalence and types of neural tube defects and the types of anomalies co-occurring with neural tube defects in 6 years before fortification of cereal grain flour with folic acid (1992-1998) and 20 years after fortification (1999-2018) in South Carolina, a state with a historically high prevalence of these birth defects. Full-Text PDF" @default.
- W3094521167 created "2020-10-29" @default.
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- W3094521167 date "2020-11-01" @default.
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- W3094521167 title "Neural tube defects persist despite fortification" @default.
- W3094521167 doi "https://doi.org/10.1016/j.jpeds.2020.09.025" @default.
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