Periconceptional folate deficiency and implications in neural tube defects.
Nutritional deficiencies are preventable etiological and epigenetic factors causing congenital abnormalities, first cause of infant mortality. Folate deficiency has a well-established teratogenic effect, leading to an increasing risk of neural tube defects. This paper highlights the most recent medical literature about folate deficiency, be it maternal or paternal. It then focuses on associated deficiencies as nutritional deficiencies are multiple and interrelated. Observational and interventional studies have all been consistent with a 50-70% protective effect of adequate women consumption of folates on neural tube defects. Since strategies to modify women's dietary habits and vitamin use have achieved little progress, scientific as well as political effort is mandatory in order to implement global preventive public health strategies aimed at improving the alimentation of women in reproductive age, especially folic acid supplementation. Even with the recent breakthrough of fetal surgery for myelomeningocele, the emphasis should still be on prevention as the best practice rather than treatment of neural tube defects.
Department of Obstetrics and Gynecology, St Joseph University, Hôtel-Dieu de France, 1100 Beirut, Lebanon.
J
J
Safi
L
L
Joyeux
G E
GE
Chalouhi
D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D005494:Folic Acid Deficiency / Q000150:complications* / Q000188:drug therapy / Q000517:prevention & control; D006801:Humans; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects; D009436:Neural Tube Defects / Q000209:etiology* / Q000517:prevention & control; D018812:Paternal Exposure / Q000009:adverse effects; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000517:prevention & control; D039401:Prenatal Nutritional Physiological Phenomena; D014803:Vitamin B Complex / Q000627:therapeutic use
D014803:Vitamin B Complex; D005492:Folic Acid