Vitamins, folic acid and neural tube defects: Comments on investigations in the United States

1991 ◽  
Vol 11 (8) ◽  
pp. 641-648 ◽  
Author(s):  
Joe Leigh Simpson ◽  
James L. Mills ◽  
George G. Rhoads ◽  
George C. Cunningham ◽  
Howard J. Hoffman ◽  
...  
Keyword(s):  
United States ◽  
Folic Acid ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
The United States

scholarly journals Perspective: Time to Resolve Confusion on Folate Amounts, Units, and Forms in Prenatal Supplements

2020 ◽  
Vol 11 (4) ◽  
pp. 753-759 ◽  
Author(s):  
Leila G Saldanha ◽  
Johanna T Dwyer ◽  
Carol J Haggans ◽  
James L Mills ◽  
Nancy Potischman
Keyword(s):  
United States ◽  
Folic Acid ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
The United States ◽  
Chemical Forms ◽  
Dietary Folate ◽  
Intake Level

ABSTRACT Folate-containing prenatal supplements are commonly consumed in the United States, but inconsistencies in units of measure and chemical forms pose challenges for providing authoritative advice on recommended amounts. New regulations require folate to be declared as micrograms of dietary folate equivalents (DFE) on product labels, whereas intake recommendations for reducing the risk of neural tube defects (NTDs) and the Tolerable Upper Intake Level are expressed as micrograms of folic acid. Today, >25% of prenatal supplements contain folate as synthetic salts of L-5-methyltetrahydrofolate (L-5-MTHF), but recommendations do not include this form of the vitamin. Harmonizing units of measure and addressing newer forms of folate salts in intake recommendations and in the prevention of NTDs would resolve the confusion.

scholarly journals Neural Tube Defects and Maternal Folate Intake Among Pregnancies Conceived After Folic Acid Fortification in the United States

2008 ◽  
Vol 169 (1) ◽  
pp. 9-17 ◽  
Author(s):  
B. S. Mosley ◽  
M. A. Cleves ◽  
A. M. Siega-Riz ◽  
G. M. Shaw ◽  
M. A. Canfield ◽  
...  
Keyword(s):  
United States ◽  
Folic Acid ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
The United States ◽  
Folate Intake ◽  
Folic Acid Fortification

scholarly journals Gene Environment Interactions in the Etiology of Neural Tube Defects

2021 ◽  
Vol 12 ◽  
Author(s):  
Richard H. Finnell ◽  
Carlo Donato Caiaffa ◽  
Sung-Eun Kim ◽  
Yunping Lei ◽  
John Steele ◽  
...  
Keyword(s):  
United States ◽  
Folic Acid ◽  
Spina Bifida ◽  
Birth Defects ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
The United States ◽  
Model Systems ◽  
Posterior Portion ◽  
Gene Environment

Human structural congenital malformations are the leading cause of infant mortality in the United States. Estimates from the United States Center for Disease Control and Prevention (CDC) determine that close to 3% of all United States newborns present with birth defects; the worldwide estimate approaches 6% of infants presenting with congenital anomalies. The scientific community has recognized for decades that the majority of birth defects have undetermined etiologies, although we propose that environmental agents interacting with inherited susceptibility genes are the major contributing factors. Neural tube defects (NTDs) are among the most prevalent human birth defects and as such, these malformations will be the primary focus of this review. NTDs result from failures in embryonic central nervous system development and are classified by their anatomical locations. Defects in the posterior portion of the neural tube are referred to as meningomyeloceles (spina bifida), while the more anterior defects are differentiated as anencephaly, encephalocele, or iniencephaly. Craniorachischisis involves a failure of the neural folds to elevate and thus disrupt the entire length of the neural tube. Worldwide NTDs have a prevalence of approximately 18.6 per 10,000 live births. It is widely believed that genetic factors are responsible for some 70% of NTDs, while the intrauterine environment tips the balance toward neurulation failure in at risk individuals. Despite aggressive educational campaigns to inform the public about folic acid supplementation and the benefits of providing mandatory folic acid food fortification in the United States, NTDs still affect up to 2,300 United States births annually and some 166,000 spina bifida patients currently live in the United States, more than half of whom are now adults. Within the context of this review, we will consider the role of maternal nutritional status (deficiency states involving B vitamins and one carbon analytes) and the potential modifiers of NTD risk beyond folic acid. There are several well-established human teratogens that contribute to the population burden of NTDs, including: industrial waste and pollutants [e.g., arsenic, pesticides, and polycyclic aromatic hydrocarbons (PAHs)], pharmaceuticals (e.g., anti-epileptic medications), and maternal hyperthermia during the first trimester. Animal models for these teratogens are described with attention focused on valproic acid (VPA; Depakote). Genetic interrogation of model systems involving VPA will be used as a model approach to discerning susceptibility factors that define the gene-environment interactions contributing to the etiology of NTDs.

Which infants are at risk for fatal neural tube defects in the United States?

2008 ◽  
Vol 15 (4) ◽  
pp. A27-A27
Author(s):  
J Petrini ◽  
Rb Russell ◽  
K Damus ◽  
C Alter ◽  
D Mattison
Keyword(s):  
United States ◽  
At Risk ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
The United States

The recurrence risk for neural tube defects in the United States: A collaborative study

1980 ◽  
Vol 5 (3) ◽  
pp. 309-314 ◽  
Author(s):  
S. Cowchock ◽  
E. Ainbender ◽  
G. Prescott ◽  
B. Crandall ◽  
L. Lau ◽  
...  
Keyword(s):  
United States ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Collaborative Study ◽  
Recurrence Risk ◽  
The United States
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