scholarly journals Neural tube defects: how many cases could have been prevented in Portugal?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Braz ◽  
A Machado ◽  
I Kislaya ◽  
C M Dias

Abstract Neural tube defects (NTD) occurs when the neural tube does not close properly until the 28th day of foetal life. About 70% of NTD can be prevent if women start folic acid (FA) before pregnancy and until the end of 1st trimester. Portugal has this primary prevention since 1998, however the secondary prevention of NTD with TOPFA is still high (80%). The aim of this study is to describe when FA intake was started and estimate the number of cases that would have be prevented if FA intake started before pregnancy as recommended. A cross-sectional study using data from the National Registry of Congenital Anomalies between 2004-2017 was performed. The temporal evolution of the beginning of FA intake was analysed with Cochran-Armitage test for proportions. The proportion of preventable cases was estimated considering the 70% prevention fraction and the number of NTD cases registered in RENAC that occurred in pregnancies without the recommended FA supplementation. On average, 13.8% of all women started FA before pregnancy, 46.2% during 1st trimester and 6.1% did not take folic acid. A statistically significant trend (p < 0.001) was observed in the group that started before pregnancy with increase from 6.8% in 2004 to 17.9% in 2017. The prevalence of NTD was 4.2 cases / 10,000 births, ranging from 2 cases / 10,000 births (2007) to 7 cases / 10,000 births (2014). Between women who had a pregnancy with NTD, 16.8% started FA before pregnancy, 42.2% in the 1st trimester and 9.7% did not take the supplement. If all women had started FA before pregnancy, an estimated 202 NTD cases could have been prevented. In Portugal, the proportion of women who adhere to this measure is very low, similarly to other European countries, compromising the primary prevention of NTD. Perhaps due to the high percentage of TOPFA, the idea that this anomalies continue to affect our children has been lost. Primary prevention of NTDs should be encouraged with measures that promote FA supplementation. Key messages Primary prevention of NTD is possible. Proportion of women who adhere to primary prevention is low.

1970 ◽  
Vol 6 (2) ◽  
pp. 952-956
Author(s):  
Buwembo William ◽  
Apolot Priscilla Obore ◽  
Samuel Ziraba ◽  
Mesarch Kange ◽  
Ian Guyton Munabi ◽  
...  

Spina bifida is one of the commonest neural tube defects. Though food fortification with folic acid has been reported to reduce spina bifida, the incidence of spina bifida and the benefits of taking folic acid have not been documented in many developing countries including Uganda. This study set out to determine the incidence of spina bifida and related skeletal neural tube defects in the skeletons currently housed in the Galloway skeletal collection at Makererere University College of Health Sciences, Anatomy department with the aim of using the data to extrapolate on the usefulness of food fortification with folic acid. This was a descriptive cross sectional study on 226 skeletons in the Galloway osteological collection examined by an experienced anatomist for features of neural tube defects that ranged from non-fusion of the spinal arches to total absence of vertebral structures. Of the skeletons examined 43/226 (19%) had spina bifida. Of these 38/43 (88%) were male, suggesting a higher incidence of spina bifida in males than in the females. Overall 55.2% of the skeletons were within the age range of 20-55 years. This historical study highlights possible differences in the maternal micro nutrient status in the early months of pregnancy for various African populations as shown by the differences in the prevalence rates of minor spina bifida defects in the Galloway osteological collection. There is need for baseline studies on folic acid levels during pregnancy and the various local dietary sources of folic acid for Africans.Key words: Neural tube defects, osteology


Author(s):  
Neha Choudhary ◽  
Preeti Manhas ◽  
Akash Narangyal ◽  
Rohan Singh Manhas

Background: Folic acid reduces the risk of birth defects, including neural tube defects (NTDs). It reduces the risk of miscarriage and fetal death as well as folate-deficiency anemia. Folate status is particularly important before conception and during the first 12 weeks of pregnancy. Objective was to assess knowledge and consumption of folic acid among teachers in the reproductive age group.Methods: 336 school teachers selected from government and private schools (primary/middle/secondary/higher secondary) by simple random sampling technique. Teacher’s knowledge and consumption of folic acid and associated factors was studied using a pre- tested; self- administered questionnaire.Results: 95% teachers had heard about folic acid, 57% knew about neural tube defects. 53% were aware of the role of folic acid in NTDs. 66% had knowledge about the best timing for its intake. 56% were aware about the sources rich in folic acid. 75% believed that foods are the best source of folic acid, 80% believed that taking foods rich in folic acid and tablets are sufficient to maintain body stores.49% were taking folic acid presently. 66% of the participants were taking folic acid under medical advice, 29% due to the recommendations by their family/friends while self-initiation was reported in only 5% of the individuals.Conclusions: IEC activities needs to be conducted among different strata of population so that the intake of folic acid could be increased and associated factors effecting its intake and absorption could be taken care of.


Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 357
Author(s):  
Mohamed N. Al Arifi ◽  
Ali M. Alqahtani ◽  
Abdulaziz Naif Alotaibi ◽  
Salmeen D. Babelghaith ◽  
Abdulrahman Alwhaibi ◽  
...  

Background and objectives: Neural tube defects are congenital anomalies which canlead to infant death and serious disability. They are initiated during embryogenesis, between the 23rd and 27th day of fetal life, and can be prevented by the administration of folic acid. Therefore, this study aims to evaluate the knowledge and practice of Saudi women at childbearing age regarding NTDs and FA supplementation. Methodology: This is a cross-sectional study on Saudi women of reproductive age who were asked to complete an online survey to examine their knowledge and practice regarding folic acid supplementation and neural tube defects. Descriptive and simple linear regression analyses were conducted using SPSS v.26 (SPSS Inc., Chicago, IL, USA). Results: A total of 613 women have completed the questionnaire, from which the majority (46.7%) were aged between 36 and 40 years. About 94% of women heard about folic acid and 80% indicated that its deficiency has some relation to neural tube defects. Approximately 37%, 25.3%, and 23.2% of women reported the proper time for folic acid intake to be during first trimester of pregnancy, before pregnancy, or throughout pregnancy, respectively. Linear regression analysis revealed that increase age and education were significantly correlated with a decrease in folic acid administration (p = 0.008) and (p = 0.001), respectively. However, there was no association between time of folic acid administration and income or number of parities. Conclusion: Despite the acceptable level of awareness about the relation of folic acid and neural tube defects, our results revealed that more education is required towards the proper time of supplementation among Saudi childbearing women.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mingming Cui ◽  
Xiao-Lin Lu ◽  
Yan-Yu Lyu ◽  
Fang Wang ◽  
Xiao-Lu Xie ◽  
...  

Abstract Background The prevalence of neural tube defects (NTDs) in China declined during 2000–2017 with periconceptional folic acid (FA) supplementation, which is effective in reducing the risk of birth defects. We aimed to assess the knowledge and actual use of FA among Chinese pregnant women and to explore factors associated with FA use before pregnancy. Methods All data were collected in face-to-face interviews during health visits among pregnant women. We collected information about knowledge and use of FA supplements and demographic, socioeconomic, and health status. One maternity and childcare hospital was chosen in each of four cities: Beijing, Huaibei, Kunming, and Haikou. In total, 435 pregnant women were randomly recruited for interviews conducted from June to December 2016. Results A total of 428 pregnant women were included in this survey. Of these, 82.0% (351/428) knew that FA can prevent NTDs, and 75.9% (325/428) knew the correct time to take FA. Overall, 65.9% (282/428) of women knew both that FA can prevent NTDs and the recommended time to take FA before pregnancy. Approximately 95.1% (407/428) of women reported having ever taken FA, only 46.3% (198/428) had begun to take FA supplementation before conception, and 64.5% (109/169) of women from rural areas failed to take FA before pregnancy. Women living in northern China (odds ratio [OR] = 1.81, 95% confidence interval [CI], 1.18–2.77), those with unplanned pregnancy (OR = 1.99, 95% CI 1.30–3.04), and highly educated women (OR = 2.37, 95% CI 1.45–3.88) were more likely to know about FA. Women who were homemakers (OR = 1.94, 95% CI 1.21–3.11) and had unplanned pregnancy (OR = 6.18, 95% CI 4.01–9.53) were less likely to begin taking FA before pregnancy. Conclusions Our survey showed that most pregnant women knew about FA. Although preconception intake of FA can help to reduce NTDs, improving the rate of FA intake before pregnancy is needed in urban areas of China, especially among homemakers and women from rural areas or with unplanned pregnancy. Campaigns are needed to increase awareness about FA and FA use before pregnancy among rural women, homemakers, and those with unplanned pregnancy and lower education levels.


PEDIATRICS ◽  
1982 ◽  
Vol 70 (4) ◽  
pp. 648-650
Author(s):  
K. M. Laurence

It is generally agreed that neural tube defects (NTD) have a multifactorial etiology when genetic factors render the developing fetus susceptible to intrauterine environmental factors acting during the fourth week of gestation to interfere with the orderly closure of the neural tube.1 As there is little likelihood that anything can be done about the genetic background, primary prevention would therefore be dependent on eliminating these factors from the environment or avoiding them. My intention here is to enlarge on some aspects of primary prevention of NTD as outlined by Smithells in an earlier issue (Pediatrics 69:498, 1982).2 One environmental factor, poor maternal nutrition and, more particularly, folic acid deficiency seems now to have been identified, but there are almost certainly a number of others.


2011 ◽  
Vol 14 (7) ◽  
pp. 1142-1147 ◽  
Author(s):  
Ziqian Zeng ◽  
Ping Yuan ◽  
Yanping Wang ◽  
Xi Ma ◽  
Jun Zhu

AbstractObjectiveTo measure folic acid awareness and intake rates among women of childbearing age in certain areas of China with a high prevalence of neural tube defects (NTD).DesignA cross-sectional survey was carried out utilising a nineteen-item questionnaire enquiring into individual women's knowledge of, attitude towards and practice of folic acid supplementation.SettingA total of 293 low-income counties in six provinces of China.SubjectsWomen aged 19–44 years from six provinces with a high prevalence of NTD recruited from June to August 2008.ResultsAmong 33 025 participants, 57 % had heard of folic acid but only 15 % knew all of the core information. The intake rate was 12 %; only 8 % took the recommended dose and only 4 % of non-pregnant women took folic acid. Some women did not take folic acid because they did not know that they should take it (49 %) or they had misconceptions about it (24 %). According to logistic regression analysis, rural residence was a risk factor for folic acid awareness. Ethnicity, educational level, average annual income per person and pregnancy were the influencing factors of folic acid awareness and folic acid intake.ConclusionsAlthough more than half of the respondents had heard of folic acid, the intake rate was still very low in areas with a high prevalence of NTD. Thus, more efforts are needed to increase folic acid awareness and intake among women of reproductive age in these areas.


2019 ◽  
Author(s):  
MESELECH AMBAW DESSIE ◽  
Ayanaw Worku Berihun

Abstract Abstract Background: Neural tube defects are congenital anomalies of the brain, spinal cord, and their surrounding structures. Folic acid intake before and during the early weeks of pregnancy could reduce neural tube and other birth defects. Folic acid usage in the protective period of pregnancy against the neural tube defects is related to high level of awareness. This study aimed at evaluating the level of folic acid awareness for the prevention of neural tube defects and associated factors among pregnant women in Adama, South East Ethiopia. Method: A descriptive cross-sectional study design was used. 398 consented pregnant women attending antenatal care in Adama were the participants of the study. The women were selected by using a systematic random sampling method. A structured pre-tested interviewer-administered questionnaire was used to collect the data. The questionnaire was concerned with participants’ demographic information, and their awareness about folic acid, roles of folic acid, and the recommended time of intake. Data were analyzed using SPSS version 20 statical software. Simple and multiple binary logistic regression analyses were conducted. 95% confidence interval and p-value were used to evaluate the association between dependent and independent variables. Results: Of the interviewed women, 20.9% reported having heard or read something about folic acid supplements. But only 1.01% and 6.03% were aware of the recommended time of intake and the role of folic acid in preventing neural tube defects and other congenital anomalies respectively. The healthcare providers were the primary source of information about folic acid, which account 78.3%. Folic acid awareness was associated with age, educational status, household monthly income, week of pregnancy at the first antenatal visit, any complication during current pregnancy, and use of folic acid during current pregnancy. Conclusions: Most of the pregnant women were not aware of folic acid, its importance and the recommended time of intake for preventing neural tube defects. Further effort is required from policymakers, healthcare providers, the media, and community to increase women's awareness about folic acid. Keywords: Folic acid, Awareness, Neural tube defects


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