[Effects of public initiatives aimed at reducing neural tube defects with folic acid supplementation].
BACKGROUND
In order to prevent neural tube defects, a daily supplement of 400 microg (microgram) folic acid has been recommended in Norway since 1998, during the last month before conception and the first two or three months of pregnancy. Compliance with and effects of this recommendation has recently been evaluated in Norway in a report to the Directorate of Health and Social Welfare.


METHODS
Reports published on periconceptional folic acid intake in Norway and some other countries from 1998 to autumn 2003 have been evaluated.


RESULTS
In spite of several information activities, few Norwegian women start folic acid supplementation before verified pregnancy. The supplementation is started too late for the prevention of neural tube defects. A reduction is not observed in Norway. Internationally, information has not proven effective either, whereas compulsory fortification of foods with folic acid has been associated with reduced incidence. Information about periconceptional folic acid intake should be intensified. Compulsory fortification of foods with folic acid will affect the whole population, not only the target group of fertile women. If ongoing large intervention studies show improved clinical prognosis for patients with cardiovascular disease, this will be an additional argument for fortification of foods.
Staff
Anne Cathrine
AC
Kvinnesenteret, Kvinne-barn-divisjonen, Ullevål universitetssykehus, HF 0450 Oslo. annetine.staff@ulleval.no
Løken
Elin Bjørge
EB
Holven
Kirsten
K
Sygnestveit
Kari
K
Vollset
Stein Emil
SE
Smeland
Sigbjørn
S
D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D005527:Food, Fortified; D006266:Health Education; D006801:Humans; D009436:Neural Tube Defects / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D016742:Preconception Care; D011247:Pregnancy
D005492:Folic Acid