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Folate awareness and the prevalence of neural tube defects in South Australia, 1966–2007
Author(s) -
Chan Annabelle C,
Essen Phillipa,
Scott Heather,
Haan Eric A,
Sage Leonie,
Scott Joan,
Gill Tiffany K,
Nguyen AnhMinh T
Publication year - 2008
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2008.tb02183.x
Subject(s) - folic acid , medicine , fortification , pregnancy , neural tube defect , environmental health , neural tube , obstetrics , demography , fetus , food science , biology , genetics , sociology , embryo , microbiology and biotechnology
Objectives: To ascertain changes in: women's knowledge of the role of folic acid in the prevention of neural tube defects (NTDs); intake of folic acid among pregnant women; and prevalence of NTDs in South Australia. Design, setting and participants: Computer‐assisted telephone interviews of South Australian households from 1994 to 2007 over a period encompassing a statewide folate promotion campaign (1994–1995), continuing folate promotion, as well as the introduction of voluntary folate fortification of foods (1996); ascertainment of the total prevalence of NTDs from births and terminations of pregnancy from 1966 to 2007. Main outcome measures: Changes in women's knowledge of the role of folic acid in the prevention of NTDs; changes in the prevalence of NTDs. Results: From 1994 to 2006 and 2007, knowledge about the role of folic acid increased from 25% to 77% ( P < 0.001) and knowledge that folic acid needs to be taken in the periconceptional period increased from 12% to 39% ( P < 0.001). The proportion of pregnant women who increased their periconceptional intake of folate rose from 61% in 1998 to 81% in 2006 and 2007 ( P < 0.001), with significant increases in the consumption of fortified cereals (from 15% to 29%) and folic acid tablets (from 37% to 64%). The total prevalence of NTDs fell from 2.06 per 1000 births in 1986–1990 to 1.23 per 1000 births in 2002–2007 (relative risk, 0.60; 95% CI, 0.48–0.74; P < 0.001). Conclusions: Folate promotion and voluntary fortification of certain foods with folic acid were associated with increased awareness of the role of periconceptional folic acid, increased folate consumption and a reduction in the prevalence of NTDs in South Australia by 40% (95% CI, 26%–52%).