Impact of folic acid fortification of the US food supply on the occurrence of neural tube defects
Impact of folic acid fortification of the US food supply on the occurrence of neural tube defects
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DOI：
10.1001/jama.285.23.2981
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发表时间：
2001-06-20
影响因子：
120.7
通讯作者：
Wong, LYC
中科院分区：
文献类型：
--
作者：
Honein, MA;Paulozzi, LJ;Wong, LYC
在怀孕前和怀孕早期，每天摄入400微克叶酸可以显著降低神经管缺陷（NTD）的发生率。然而，在食物强化之前，估计只有29%的美国育龄妇女每天服用含有400微克叶酸的补充剂。1996年3月，美国食品和药物管理局批准在强化谷物产品中添加叶酸，并于1998年1月强制要求添加叶酸。目的评价食品中添加叶酸对新生儿NTD患病率的影响。在1990年1月至1999年12月期间，主要指标强化前脊柱裂和无脑畸形的出生证明报告（1995年10月至1996年12月）与强制性强化后相比（1998年10月至1999年12月）结果新生儿出生证NTD患病率由强化前的37.8/10万下降到30.5/10万。10万例活产婴儿在强制性叶酸强化后受孕，下降19%（患病率比[PR]，0.81; 95%可信区间[CI]，0.75-0.87），同期新生儿NTD患病率从53.4/10万下降到46.5/10万（PR，0.87; 95%CI，0.64-1.18）的妇女谁只接受了第三个三个月或没有产前护理。结论一个19%的新台币出生率下降发生在叶酸强化美国食品供应。然而，除营养强化以外的其他因素可能也导致了这一下降。
Context Daily consumption of 400 mug of folic acid before conception and during early pregnancy dramatically reduces the occurrence of neural tube defects (NTDs), Before food fortification, however, only an estimated 29% of US reproductive-aged women were taking a supplement containing 400 mug of folic acid daily. The US Food and Drug Administration authorized addition of folic acid to enriched grain products in March 1996, with compliance mandatory by January 1998.Objective To evaluate the impact of food fortification with folic acid on NTD birth prevalence.Design, Setting, and Population National study of birth certificate data for live births to women in 45 US states and Washington, DC, between January 1990 and December 1999,Main Outcome Measure Birth certificate reports of spina bifida and anencephaly before fortification (October 1995 through December 1996) compared with after mandatory fortification (October 1998 through December 1999).Results The birth prevalence of NTDs reported on birth certificates decreased from 37.8 per 100000 live births before fortification to 30.5 per 100000 live births conceived after mandatory folic acid fortification, representing a 19% decline (prevalence ratio [PR], 0.81; 95% confidence interval [CI], 0.75-0.87), During the same period, NTD birth prevalence declined from 53.4 per 100000 to 46.5 per 100000 (PR, 0.87; 95% CI, 0.64-1.18) for women who received only third-trimester or no prenatal care.Conclusions A 19% reduction in NTD birth prevalence occurred following folic acid fortification of the US food supply. However, factors other than fortification may have contributed to this decline.