title: Folic Acid Intake and Neural Tube Defects: Two Egyptian Centers Experience.
abstract: Neural tube defects (NTDs) are a group of congenital malformations with worldwide distribution and complex etiopathogenesis. Folic acid plays a pivotal role in their prevention. We aimed to identify the protective effect of folic acid intake against NTDs and its dependence on different socioeconomic and environmental factors in a cohort of mothers in Egypt. A cross-sectional study was carried over a period of 12 months on mothers who gave birth to babies with NTDs (group 1) and a control group with healthy offsprings (group 2). Both groups completed 2 questionnaires: food frequency questionnaire targeting the daily folate intake, and socioeconomic status and medical history questionnaire. Both groups of mothers received folate <800 μg/day, recommended for pregnant women. A strong association was detected between NTDs and urban residency with medium educated mothers, with negative consanguinity, who had folate intake < 400 μg daily, and who had their food long cooked. Each of these factors separately had a limited impact to cause NTDs, but when present together they did augment each other. Interestingly enough is the role of fava bean, cauliflower, spinach, and mango in predisposing of NTDs in the presence of the above-mentioned factors. The protective effect of folic acid intake against NTDs may depend on the synergism of different socioeconomic and environmental factors (which differ from country to another). In Egypt, females especially the medium-educated who live in urban areas should be well-informed with the value of folate intake in the periconceptional period.
authors.affiliation: From the Professor of Pediatrics and Pediatric Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt (MHE-S); Associate Professor of Pediatrics and Pediatric Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt (NMK); Consultant Obstetrician and Gynecologist, Red Crescent Hospital, Ministry of Health and Population, Cairo, Egypt (MAE); Professor of Nutrition, Institute of Nutritional Sciences, University of Giessen, Giessen, Germany (MK); Professor of Nutrition, National Research Center, Cairo, Egypt (LH); Lecturer of Pediatrics and Neonatology, Faculty of Medicine, Cairo University, Cairo, Egypt (EAAA); Lecturer of Obstetrics and Gynecology, Faculty of Medicine, Fayoum University, Fayoum, Egypt (YZAA); Associate Professor of Pediatrics and Neonatology, Faculty of Medicine, Benha University, Egypt (AAA, MAS); Fellow in nutrition, Institute of Nutritional Sciences, University of Giessen, Giessen, Germany (MK); and Professor of Nutrition, Institute of Nutritional Sciences, University of Giessen, Giessen, Germany (MK).
authors.forename: Mortada H
authors.initials: MH
authors.lastname: El-Shabrawi
authors.forename: Naglaa Mohamed
authors.initials: NM
authors.lastname: Kamal
authors.forename: Mona Abbas
authors.initials: MA
authors.lastname: Elhusseini
authors.forename: Laila
authors.initials: L
authors.lastname: Hussein
authors.forename: Enas Abdallah Ali
authors.initials: EAA
authors.lastname: Abdallah
authors.forename: Yahia Zakaria Abdelalim
authors.initials: YZA
authors.lastname: Ali
authors.forename: Ahmed Abelfattah
authors.initials: AA
authors.lastname: Azab
authors.forename: Mostafa Abdelazim
authors.initials: MA
authors.lastname: Salama
authors.forename: Muna
authors.initials: M
authors.lastname: Kassab
authors.forename: Michael
authors.initials: M
authors.lastname: Krawinkel
mesh_terms: D000293:Adolescent; D000328:Adult; D004032:Diet / Q000706:statistics & numerical data; D004534:Egypt / Q000453:epidemiology; D016021:Epidemiologic Studies; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D006801:Humans; D009436:Neural Tube Defects / Q000453:epidemiology / Q000517:prevention & control*; D011247:Pregnancy; D012959:Socioeconomic Factors; D014803:Vitamin B Complex / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D014803:Vitamin B Complex; D005492:Folic Acid