Are Women with Recent Live Births Aware of the Benefits of Folic Acid?

2001 ◽  
Author(s):  
Indu B. Ahluwalia ◽  
Katherine Lyon Daniel
Keyword(s):  
Folic Acid ◽  
Live Births

scholarly journals Folic acid supplementation and risk for congenital limb reduction defects in China

2019 ◽  
Vol 48 (6) ◽  
pp. 2010-2017 ◽  
Author(s):  
Jufen Liu ◽  
Zhiwen Li ◽  
Rongwei Ye ◽  
Aiguo Ren ◽  
Jianmeng Liu
Keyword(s):  
Folic Acid ◽  
Southern China ◽  
Large Population ◽  
Northern China ◽  
Population Based ◽  
Folic Acid Supplementation ◽  
Live Births ◽  
Limb Reduction ◽  
Congenital Limb ◽  
Gestational Week

Abstract Background Folic acid (FA) supplementation prevents neural tube defects, but there are mixed results for its ability to prevent limb reduction defects. We examined whether a preventive effect of FA supplementation exists for congenital limb reduction defects in a large population in China. Methods Data from a large population-based cohort study in China were used to evaluate the effects of FA supplementation on birth defects. All births at 20 complete gestational weeks, including live births, stillbirths and pregnancy terminations, and all structural congenital anomalies, regardless of gestational week, were recorded. A total of 247 831 singleton live births delivered at gestational ages of 20–42 weeks to women from northern and southern China with full information on FA intake were included. Limb reduction defects were classified by subtype and maternal FA supplementation. Results The prevalence of limb reduction defects was 2.7 per 10 000 births among women who took FA compared with 9.7 per 10 000 births among those who did not take FA in northern China; the prevalence was 4.5 and 3.8 per 10 000 births, respectively, in southern China. In both unadjusted and adjusted analyses, the estimated relative risk for upper limb reduction defects [odds ratio (OR) = 0.17, 95% confidence interval (CI): 0.04, 0.63] and total limb reduction defects (OR = 0.24, 95% CI: 0.08, 0.70) in northern China, but not for lower limb reduction defects ,was significantly decreased in association with FA supplementation in northern China. There was no association between FA supplementation and either an increased or decreased risk for limb reduction defects in southern China. Conclusions FA supplementation successfully reduces the prevalence of limb reduction defects in northern China, whose population has low folate concentrations.

scholarly journals Do high levels of folic acid in women’s blood impact the outcome of IVF?

2020 ◽  
Vol 13 (4) ◽  
pp. 313-325
Author(s):  
M. A. Polzikov ◽  
D. V. Blinov ◽  
T. I. Ushakova ◽  
Z. B. Barakoeva ◽  
L. A. Vovk ◽  
...  
Keyword(s):  
Folic Acid ◽  
Polycystic Ovary ◽  
Practical Interest ◽  
The Body ◽  
Phase Iii ◽  
Male Factor ◽  
Tubal Infertility ◽  
Hormonal Stimulation ◽  
Reference Drug ◽  
Live Births

Of significant scientific and practical interest is the relationship between the blood plasma levels of folic acid at preconception and the outcome of pregnancy. A phase III clinical trial on the efficacy and safety of the biosimilar follitropin alfa has recently been completed within the ongoing assisted reproductive technology (ART) programs. The results confirmed the therapeutic equivalence of the investigational agent to the reference drug. In this trial, women with tubal infertility or male factor infertility were included. The study did not include women with endometriosis and polycystic ovary syndrome. A total of 118 patients were recruited; of those, 110 were randomized; then the 110 women underwent hormonal stimulation and 98 of them underwent embryo transfer. Blood samples were taken within a period not exceeding 28 days before the start of the stimulation; the samples were analyzed for folic acid (FA), trace elements and hormones. The results were grouped by quartiles (Q) according to the levels of FA in the blood serum: Q1 – 2.9–10.7 ng/ml, Q2 – 10.8–20.5 ng/ml, Q3 – 20.6–32.9 ng/ml, and Q4 ≥ 33.0 ng/ml. In addition, group distribution was also made according to the WHO recommendations: possible FA deficiency – 3.0–5.9 ng/ml, normal – 6.0–20.0 ng/ml, and elevated levels – more than 20 ng/ml. A significant decrease in the number of fertilized oocytes, clinical pregnancies and live births in Q4 (increased FA) compared with Q1 was found. Also, in women with high levels of FA, the number of aspirated oocytes was significantly lower than that in women with normal or decreased FA levels. We also found a significant inverse relationship between the number of aspirated oocytes and the levels of estradiol and serum FA. Plasma FA levels > 20 ng/ml detected prior to the IVF procedure may be associated with a low number of aspirated oocytes, and FA levels > 33 ng/ml – with a reduced number of fertilized oocytes, clinical pregnancies and live births. Thus, the excessive content of FA in the body can contribute to a worse outcome of IVF programs.

scholarly journals Folic acid supplements and risk for oral clefts in the newborn: a population-based study

2015 ◽  
Vol 114 (9) ◽  
pp. 1456-1463 ◽  
Author(s):  
Trude Gildestad ◽  
Tone Bjørge ◽  
Stein Emil Vollset ◽  
Kari Klungsøyr ◽  
Roy Miodini Nilsen ◽  
...  
Keyword(s):  
Folic Acid ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Population Based ◽  
Vitamin Supplement ◽  
Birth Registry ◽  
Oral Clefts ◽  
Birth Prevalence ◽  
Live Births ◽  
Relative Risks

AbstractResults from previous studies on maternal folic acid intake and infant oral clefts are inconclusive. The aim of the present study was to investigate the association between women’s use of folic acid and/or multivitamin supplements and the risk for oral cleft in the newborn. We used data from the Medical Birth Registry of Norway based on all births in Norway from 1999 to 2013. A total of 528 220 women had 880 568 pregnancies, resulting in 896 674 live births and stillbirths, of which 1623 had oral clefts (isolated oral clefts, n 1311; non-isolated oral clefts, n 312). Altogether, 21·5 % of women were vitamin supplement users before pregnancy. The birth prevalence of oral clefts was 1·81/1000 live births and stillbirths. Relative risks (RR) were estimated with log-binomial regression. For pregnancies with maternal use of vitamins, the adjusted RR for clefts overall was 0·90 (95 % CI 0·79, 1·04). The adjusted RR for cleft palate only (n 586) was 0·84 (95 % CI 0·66, 1·06) and that for cleft lip with or without cleft palate (n 1037) was 0·94 (95 % CI 0·79, 1·13). Associations were stronger for cleft cases that occurred in combination with other malformations (adjusted RR 0·63; 95 % CI 0·45, 0·88), although vitamin supplements provided no protection against isolated clefts (adjusted RR 0·98; 95 % CI 0·84, 1·15). In conclusion, our study demonstrates no statistically significant association between vitamin use and isolated oral clefts. However, we found lower risk for oral clefts that occurred in combination with other malformations.

Maternal folic acid supplementation and more prominent birth weight gain in twin birth compared with singleton birth: a cross-sectional study in northwest China

2020 ◽  
Vol 23 (16) ◽  
pp. 2973-2982 ◽  
Author(s):  
Binyan Zhang ◽  
Suhang Shang ◽  
Shanshan Li ◽  
Baibing Mi ◽  
Minmin Li ◽  
...  
Keyword(s):  
Folic Acid ◽  
Birth Weight ◽  
Northwest China ◽  
Population Based ◽  
Folic Acid Supplementation ◽  
Cross Sectional Study ◽  
Shaanxi Province ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Live Births

AbstractObjective:To investigate the association of folic acid (FA) supplementation with birth weight, the risk of small for gestational age (SGA) and low birth weight (LBW) in singleton and twin pregnancy.Design:A population-based cross-sectional survey.Setting:Twenty counties and ten districts in Shaanxi Province of northwestern China, 2013.Participants:28 174 pregnant women with their infants, covering 27 818 single live births and 356 twin live births.Results:The prevalence of FA supplementation in singletons and twins was 63·9 and 66·3 %. The mean birth weight was 3267 (sd 459·1) g, 2525 (sd 534·0) g and 2494 (sd 539·5) g; the prevalence of SGA was 14·3, 51·4 and 53·4 %; the prevalence of LBW was 3·4, 42·4 and 46·6 % among singleton, twin A and twin B, respectively. Compared with non-users, women with FA supplementation were (β 17·3, 95 % CI 6·1, 28·4; β 166·3, 95 % CI 69·1, 263·5) associated with increased birth weight, lower risk of SGA (OR 0·85, 95 % CI 0·80, 0·92; OR 0·45, 95 % CI 0·30, 0·68) and LBW (OR 0·82, 95 % CI 0·71, 0·95; OR 0·50, 95 % CI 0·33, 0·75) in singletons and twins, and more prominent effects in twins. Moreover, there were significant interactions between FA supplementation and plurality on birth weight, SGA and LBW.Conclusions:The present study suggests the association of periconceptional 0·4 mg/d FA supplementation with increased birth weight and reduced risk of SGA and LBW in both singletons and twins, and this association may be more prominent in twins.

scholarly journals Changing Lifestyles and Oral Clefts Occurrence in Denmark

2005 ◽  
Vol 42 (3) ◽  
pp. 255-259 ◽  
Author(s):  
Camilla Bille ◽  
Lisbeth B. Knudsen ◽  
Kaare Christensen
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Cleft Lip ◽  
Smoking Prevalence ◽  
Causal Association ◽  
Ecological Studies ◽  
Oral Clefts ◽  
Birth Prevalence ◽  
Live Births ◽  
Good Setting

Objective The aim of this project was to assess whether any changes in the birth prevalence of cleft lip with/without cleft palate (CL[P]) occurred in Denmark during the period 1988 through 2001. In this period an official recommendation of a supplementation of folic acid to pregnant women was introduced; furthermore, smoking among pregnant women decreased considerably. Design and Settings There are few places in which ecological studies of oral clefts are possible. Denmark provides a particularly good setting for this kind of study because of a high ascertainment and a centralized registration of subjects with cleft over the last 65 years. Participants Cleft occurrence in Denmark from 1936 to 1987 has previously been reported. Here we extend the study to include all live-born children with oral clefts born in Denmark in 1988 through 2001. Among a total of 992,727 live births, 1332 children with CL(P) were born during this period. Results and Conclusions The birth prevalence of CL(P) in Denmark has previously been found to be constant in the period 1962 through 1987, with a frequency of 1.4 to 1.5 per 1000 live births. This study showed a similar occurrence in 1988 through 2001 (birth prevalence = 1.44 per 1000 live births, 95% confidence interval = 1.37 to 1.52). The introduction of folic acid and the decrease in smoking prevalence among pregnant women do not seem to have reduced the birth prevalence. This may be due to noncompliance with the folic acid recommendation and/or only a weak causal association between folic acid and smoking and occurrence of CL(P).

scholarly journals Incidence and risk factors for neural tube defects in a Bosnian population

2021 ◽  
Author(s):  
Elmedina Mrkulić ◽  
Emina Vukas ◽  
Hajrija Maksić ◽  
Meliha Sakić ◽  
Jasmina Mahmutović ◽  
...  
Keyword(s):  
Risk Factors ◽  
Folic Acid ◽  
Bosnia And Herzegovina ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Experimental Studies ◽  
Neural Tube Closure ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Live Births

Introduction: Neural tube defects (NTDs) are multifactorial congenital anomalies of the central nervous system that results from failed neural tube closure between the 3rd and 4th weeks of embryonic development. Numerous clinical and experimental studies indicate that supplementation with folic acid before and during early pregnancy reduces the development of these anomalies. The present study examined the incidence and risk factors for NTDs and evaluated the effects of folic acid supplementation.Methods: This cross-sectional study included all children with NTDs who were hospitalized at the Pediatric Clinic, Clinical Centre University of Sarajevo during the period from January 01, 2008 to December 31, 2012. Data were collected retrospectively from the medical histories of hospitalized children. The study included children in pediatric clinics from four cantons (Sarajevo, Zenica–Doboj, Unsko–Sanski, and Central Bosnia) of the Federation of Bosnia and Herzegovina. The number of live births for the specified period in each of the four cantons was taken from a report by the Cantonal Ministry of Health.Results: Among the 69,096 live births recorded during the study period, 39 children had verified NTDs, with an overall incidence of 0.56:1,000 (or 5.6:10,000) in all four cantons. The most common NTDs were myelomeningocele with hydrocephalus (22/39, 56.4%), followed by isolated myelomeningocele (9/39, 23.1%), spina bifida occulta (7/39, 17.9%), and occipitocele (1/39, 2.6%). A total of 33.3% (13/39) of mothers took folic acid, but only one began supplementation prior to pregnancy, while 67.7% (26/39) of mothers did not take folic acid during pregnancy. NTDs were found more frequently in primiparas (53.8%), women with low education (basic school, 64.1%), and unemployed women (82.1%).Conclusion: It is important to make national recommendations for folic acid supplementation for women of reproductive age, but also change the public health policy that includes mandatory fortification of basic foods as this is the best measure for primary prevention of NTDs in the whole population regardless of employment and education status. Additional comprehensive studies are required to assess the incidence and risk factors throughout Bosnia and Herzegovina.

The Morphology of the Rat Kidney Following Folic Acid Administration

1970 ◽  
Vol 28 ◽  
pp. 200-201
Author(s):  
Aline Byrnes ◽  
Elsa E. Ramos ◽  
Minoru Suzuki ◽  
E.D. Mayfield
Keyword(s):  
Folic Acid ◽  
De Novo ◽  
Specific Activity ◽  
Rat Kidney ◽  
Present Report ◽  
Intracellular Localization ◽  
Male Rats ◽  
Renal Hypertrophy ◽  
Electron Microscopic ◽  
Biochemical Alterations

Renal hypertrophy was induced in 100 g male rats by the injection of 250 mg folic acid (FA) dissolved in 0.3 M NaHCO3/kg body weight (i.v.). Preliminary studies of the biochemical alterations in ribonucleic acid (RNA) metabolism of the renal tissue have been reported recently (1). They are: RNA content and concentration, orotic acid-c14 incorporation into RNA and acid soluble nucleotide pool, intracellular localization of the newly synthesized RNA, and the specific activity of enzymes of the de novo pyrimidine biosynthesis pathway. The present report describes the light and electron microscopic observations in these animals. For light microscopy, kidney slices were fixed in formalin, embedded, sectioned, and stained with H & E and PAS.

Efficacy of Adding Folic Acid to Foods

2012 ◽  
Vol 82 (3) ◽  
pp. 177-186 ◽  
Author(s):  
Violeta Fajardo ◽  
Gregorio Varela-Moreiras
Keyword(s):  
Folic Acid ◽  
Age Groups ◽  
Nutritional Deficiencies ◽  
Physiological Status ◽  
Food Fortification ◽  
Limited Information ◽  
Dietary Recommendations ◽  
Nutritional Education ◽  
Food Composition Tables ◽  
Staple Foods

In the past, food fortification along with nutritional education and the decrease in food costs relative to income have proven successful in eliminating common nutritional deficiencies. These deficiencies such as goiter, rickets, beriberi, and pellagra have been replaced with an entirely new set of “emergent deficiencies” that were not previously considered a problem [e.g., folate and neural tube defects (NTDs)]. In addition, the different nutrition surveys in so-called affluent countries have identified “shortfalls” of nutrients specific to various age groups and/or physiological status. Complex, multiple-etiology diseases, such as atherosclerosis, diabetes, cancer, and obesity have emerged. Food fortification has proven an effective tool for tackling nutritional deficiencies in populations; but today a more reasonable approach is to use food fortification as a means to support but not replace dietary improvement strategies (i. e. nutritional education campaigns). Folic acid (FA) is a potential relevant factor in the prevention of a number of pathologies. The evidence linking FA to NTD prevention led to the introduction of public health strategies to increase folate intakes: pharmacological supplementation, mandatory or voluntary fortification of staple foods with FA, and the advice to increase the intake of folate-rich foods. It is quite contradictory to observe that, regardless of these findings, there is only limited information on food folate and FA content. Data in Food Composition Tables and Databases are scarce or incomplete. Fortification of staple foods with FA has added difficulty to this task. Globally, the decision to fortify products is left up to individual food manufacturers. Voluntary fortification is a common practice in many countries. Therefore, the “worldwide map of vitamin fortification” may be analyzed. It is important to examine if fortification today really answers to vitamin requirements at different ages and/or physiological states. The real impact of vitamin fortification on some key biomarkers is also discussed. An important question also to be addressed: how much is too much? It is becoming more evident that chronic excessive intakes may be harmful and a wide margin of safety seems to be a mandatory practice in dietary recommendations. Finally, the “risk/benefit” dilemma is also considered in the “new” FA-fortified world.

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