title: Decline of neural tube defects cases after a folic acid campaign in Nuevo León, México.
abstract: BACKGROUND
  Nuevo León is a state in northeastern Mexico, near the border of Texas. Mean mortality rate from 1996-98 due to anencephaly cases was 0.6/1,000. In 1999 a surveillance program for the registry and prevention of neural tube defects (NTD) cases was initiated.
  
  
  METHODS
  Cases were obtained from hospitals and OB-GYN clinics by immediate notification, death certificates, or fetal death registries. Only isolated cases of NTD were included. In August 1999 a folic acid campaign was initiated with the free distribution of the vitamin to low-income women with a recommendation to take a 5.0-mg pill once a week. Number of cases and rates from 1999 to 2001 were compared (chi(2) test).
  
  
  RESULTS
  After 2 years there has been a significant reduction in the number of cases and rates. In 1999 there were 95 NTD cases and in the years 2000 and 2001 there were only 59 and 55 respectively (P < 0.001). NTD rate decreased from 1.04/1,000 in 1999 to 0.58/1,000 in 2001. Anencephaly and spina bifida rates decreased from 0.55/1,000 to 0.29/1,000 and from 0.47/1,000 to 0.22/1,000 respectively, from 1999-2001. Decrease of female cases was higher than male cases for both phenotypes.
  
  
  CONCLUSIONS
  After 2 years there was a 50% decrease in the incidence of anencephaly and spina bifida cases with a significant reduction of infant mortality and disability. These results encourage us to propose the use of a single tablet of 5.0-mg of folic acid per week as an alternative to supplementation on a daily basis.
authors.affiliation: Unidad de Genética y Defectos Congénitos, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, N.L. Mexico. lauramart@ccr.dsi.uanl.mx
authors.forename: Laura
authors.initials: L
authors.lastname: Martínez de Villarreal
authors.forename: Jesús Z Villarreal
authors.initials: JZ
authors.lastname: Pérez
authors.forename: Patricia Arredondo
authors.initials: PA
authors.lastname: Vázquez
authors.forename: Ricardo Hernández
authors.initials: RH
authors.lastname: Herrera
authors.forename: Ma Del Roble Velazco
authors.initials: Mdel R
authors.lastname: Campos
authors.forename: Roberto Ambriz
authors.initials: RA
authors.lastname: López
authors.forename: José Luis Herrera
authors.initials: JL
authors.lastname: Ramírez
authors.forename: Jesús Manuel Yañez
authors.initials: JM
authors.lastname: Sánchez
authors.forename: Juan José Morales
authors.initials: JJ
authors.lastname: Villarreal
authors.forename: Manuel Treviño
authors.initials: MT
authors.lastname: Garza
authors.forename: Adriana
authors.initials: A
authors.lastname: Limón
authors.forename: Abel Guzmán
authors.initials: AG
authors.lastname: López
authors.forename: Mario
authors.initials: M
authors.lastname: Bárcenas
authors.forename: Juan Ramón Cepeda
authors.initials: JR
authors.lastname: García
authors.forename: Andrés Sánchez
authors.initials: AS
authors.lastname: Domínguez
authors.forename: Rogelio Hernández
authors.initials: RH
authors.lastname: Nuñez
authors.forename: Jorge Luis García
authors.initials: JL
authors.lastname: Ayala
authors.forename: Jorge Garza
authors.initials: JG
authors.lastname: Martínez
authors.forename: Mario Tijerina
authors.initials: MT
authors.lastname: González
authors.forename: Carlos García
authors.initials: CG
authors.lastname: Alvarez
authors.forename: Roberto Negrete
authors.initials: RN
authors.lastname: Castro
mesh_terms: D000757:Anencephaly / Q000453:epidemiology / Q000517:prevention & control; D019587:Dietary Supplements; D004677:Encephalocele / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D009436:Neural Tube Defects / Q000453:epidemiology* / Q000517:prevention & control; D011159:Population Surveillance; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011295:Prenatal Care; D015995:Prevalence; D012042:Registries; D012424:Rural Population; D012737:Sex Factors; D016135:Spinal Dysraphism / Q000453:epidemiology / Q000517:prevention & control; D014505:Urban Population
chemical_list: D005492:Folic Acid