Primary prevention of neural-tube defects and some other congenital abnormalities by folic acid and multivitamins: history, missed opportunity and tasks

Author:

Czeizel Andrew E.1,Bártfai Zoltán2,Bánhidy Ferenc3

Affiliation:

1. Törökvész lejtõ 32, 1026 Budapest, Hungary

2. Department of Pulmonology, Elisabeth Teaching Hospital, Sopron, Hungary

3. Second Department of Obstetrics and Gynecology, Semmelweis University, School of Medicine, Budapest, Hungary

Abstract

The history of intervention trials of periconception folic acid with multivitamin and folic acid supplementation in women has shown a recent breakthrough in the primary prevention of structural birth defects, namely neural-tube defects and some other congenital abnormalities. Recently, some studies have demonstrated the efficacy of this new method in reducing congenital abnormalities with specific origin; for example, in the offspring of diabetic and epileptic mothers, and in pregnancy with high fever. The benefits and drawbacks of four possible uses of periconception folate/folic acid and multivitamin supplementation are discussed: we believe there has been a missed opportunity to implement this preventive approach in medical practice. The four methods are as follows: (i) dietary intake of folate and other vitamins, (ii) periconception folic acid/multivitamin supplementation, (iii) food fortification with folic acid, and (iv) the combination of oral contraceptives with 6S-5-methytetrahydrofolate (‘folate’).

Publisher

SAGE Publications

Subject

Pharmacology (medical)

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