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Reduction of birth prevalence rates of neural tube defects after folic acid fortification in Chile
Author(s) -
LópezCamelo Jorge S.,
Orioli Iêda M.,
Dutra Maria da Graça,
NazerHerrera Julio,
Rivera Nelson,
Ojeda María Elena,
Canessa Aurora,
Wettig Elisabeth,
Fontannaz Ana María,
Mellado Cecília,
Castilla Eduardo E.
Publication year - 2005
Publication title -
american journal of medical genetics part a
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.064
H-Index - 112
eISSN - 1552-4833
pISSN - 1552-4825
DOI - 10.1002/ajmg.a.30651
Subject(s) - anencephaly , spina bifida , medicine , fortification , pediatrics , folic acid , neural tube , population , obstetrics , demography , pregnancy , environmental health , fetus , biology , food science , embryo , genetics , sociology , microbiology and biotechnology
To verify whether the decreasing neural tube defects birth prevalence rates in Chile are due to folic acid fortification or to pre‐existing decreasing trends, we performed a population survey using a network of Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC, Latin American Collaborative Study of Congenital Malformations) maternity hospitals in Chile, between the years 1982 and 2002. Within each maternity hospital, birth prevalence rates of spina bifida and anencephaly were calculated from two pre‐fortification periods (1982–1989 and 1990–2000), and from one fortified period (2001–2002). There was no historical trend for spina bifida birth prevalence rates before folic acid fortification, and there was a 51% (minimum 27%, maximum 66%) decrease in the birth prevalence rates of this anomaly in the fortified period. The relative risks of spina bifida were homogeneous among hospitals in the two period comparisons. There was no historical trend for the birth prevalence of anencephaly comparing the two pre‐fortified periods, but the relative risks were heterogeneous among hospitals in this comparison. There was a 42% (minimum 10%, maximum 63%) decrease in the birth prevalence rate of anencephaly in the fortified period as compared with the immediately pre‐fortified period, with homogeneous relative risks among hospitals. Within the methodological constraints of this study we conclude that the birth prevalence rates for both spina bifida and anencephaly decreased as a result of folic acid fortification, without interference of decreasing secular trends. © 2005 Wiley‐Liss, Inc.