A decreasing rate of neural tube defects following the recommendations for periconceptional folic acid supplementation.
OBJECTIVE
Neural tube defects (NTDs) are the most common birth defects, resulting in severe mortality and morbidity. In 1995, the supplementation of folic acid periconceptionally was officially recommended in Germany. The impact of the recommendations on the rate of NTDs was assessed.


METHODS
An active surveillance system was established in the northern Rhine area. From 1996, all departments of obstetrics were asked to report cases of NTDs in all abortions, live births and stillbirths. Compliance with the recommendations was evaluated in a sample of mothers who delivered at the Department of Obstetrics of Düsseldorf University in 2001.


RESULTS
From 1996-2003, 520 NTDs were reported. Compared to the rate of NTDs in 1996 (10.5/10,000), the average incidence in the years 1997 to 2003 dropped (6.8/10,000). The intake of folic acid, as recommended, was low among the general population (21.1%).


CONCLUSIONS
Active surveillance data on the rate of NTDs are compatible with the maximum decrease of about 20% to be expected from data on the implementation of the recommendations. A much greater decrease in NTDs should be the challenge for the future.
Klusmann
Anne
A
Department of General Paediatrics, Children's Hospital, Heinrich Heine University, Düsseldorf, Germany. klusmann@med.uni-duesseldorf.de
Heinrich
Beate
B
Stöpler
Heike
H
Gärtner
Jutta
J
Mayatepek
Ertan
E
Von Kries
Rüdiger
R
D000757:Anencephaly / Q000453:epidemiology / Q000517:prevention & control; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D009436:Neural Tube Defects / Q000453:epidemiology / Q000517:prevention & control*; D010349:Patient Compliance; D011159:Population Surveillance; D011247:Pregnancy; D011256:Pregnancy Outcome; D039401:Prenatal Nutritional Physiological Phenomena; D014803:Vitamin B Complex / Q000627:therapeutic use*
D014803:Vitamin B Complex; D005492:Folic Acid