High rates of neural tube defects in Ukraine.
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.
Yuskiv
Nataliya
N
Volyn Regional Children's Territorial Medical Center, Lutsk, Volyn, Ukraine.
Andelin
Clark O
CO
Polischuk
Svitlana
S
Shevchuk
Oleksandr
O
Sosynyuk
Zoryana
Z
Vihovska
Tetyana
T
Yevtushok
Lyubov
L
Oakley
Godfrey P
GP
Wertelecki
Wladimir
W
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
D005492:Folic Acid