title: Trends in neural tube defect prevalence, folic acid fortification, and vitamin supplement use.
abstract: In this review, the authors analyze international trends in rates of neural tube defects (NTDs) during the past three decades. Population-based data sources include the Metropolitan Atlanta Congenital Defects Program and other US birth defects surveillance programs in the National Birth Defects Prevention Network, the International Clearinghouse for Birth Defects Monitoring Systems, and US and Canadian vital records. To analyze trends in vitamin consumption, we review data from the US National Health and Nutrition Examination Surveys and international surveys of multivitamin use. We discuss the role of factors associated with historic and continuing declines in NTD rates in most countries. These factors include the introduction and increased utilization of prenatal diagnosis, recommendations for multivitamin use in women of childbearing age, and population-wide increases in blood folate levels that have occurred since food fortification was mandated. We also discuss research needs for further NTD prevention. This is a US government work. There are no restrictions on its use.
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724, USA. rolney@cdc.gov
authors.forename: Richard S
authors.initials: RS
authors.lastname: Olney
authors.forename: Joseph
authors.initials: J
authors.lastname: Mulinare
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada / Q000453:epidemiology; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage* / Q000097:blood / Q000378:metabolism; D005527:Food, Fortified / Q000592:standards; D006801:Humans; D007231:Infant, Newborn; D009436:Neural Tube Defects / Q000453:epidemiology* / Q000517:prevention & control; D011159:Population Surveillance; D011247:Pregnancy; D011296:Prenatal Diagnosis; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D014815:Vitamins / Q000008:administration & dosage*
chemical_list: D014815:Vitamins; D005492:Folic Acid