title: High rates of neural tube defects in Ukraine.
abstract: BACKGROUND
  Oral consumption of synthetic folic acid can prevent neural tube defects (NTDs), which are some of the most severe congenital anomalies. The prevalence of NTDs in Ukraine and other countries of the former U.S.S.R. has not been well studied. We determined the prevalence of NTD-affected pregnancies in Northwestern Ukraine as background for policy decisions related to flour fortification in this country.
  
  
  METHODS
  The Ukrainian-American Birth Defects Program was established in 1999 and conducts population- based surveillance of birth defects in several oblasts (states) of Ukraine. We determined the prevalence of NTDs in the Volyn and Rivne oblasts of Northwestern Ukraine for three years, 2000-2002.
  
  
  RESULTS
  There were 75,928 births in the two oblasts in 2000-2002. There were 159 cases of NTDs among live births, stillbirths, and induced abortions. The prevalence of NTDs in the two oblasts in Northwestern Ukraine is 2.1 per 1000 births.
  
  
  CONCLUSIONS
  The prevalence of NTD-affected pregnancies we found in Northwestern Ukraine is almost four times what it should be. This prevalence suggests that population folate deficiency is widespread in Ukraine. Universal folic acid fortification of flour milled in Ukraine is urgently needed to end this epidemic of birth defects. Such fortification would be expected to prevent folate deficiency anemia, heart attacks, and strokes.
authors.affiliation: Volyn Regional Children's Territorial Medical Center, Lutsk, Volyn, Ukraine.
authors.forename: Nataliya
authors.initials: N
authors.lastname: Yuskiv
authors.forename: Clark O
authors.initials: CO
authors.lastname: Andelin
authors.forename: Svitlana
authors.initials: S
authors.lastname: Polischuk
authors.forename: Oleksandr
authors.initials: O
authors.lastname: Shevchuk
authors.forename: Zoryana
authors.initials: Z
authors.lastname: Sosynyuk
authors.forename: Tetyana
authors.initials: T
authors.lastname: Vihovska
authors.forename: Lyubov
authors.initials: L
authors.lastname: Yevtushok
authors.forename: Godfrey P
authors.initials: GP
authors.lastname: Oakley
authors.forename: Wladimir
authors.initials: W
authors.lastname: Wertelecki
mesh_terms: D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D006801:Humans; D009436:Neural Tube Defects / Q000453:epidemiology* / Q000517:prevention & control; D011159:Population Surveillance; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D012189:Retrospective Studies; D014455:Ukraine / Q000453:epidemiology
chemical_list: D005492:Folic Acid