Neural Tube Defects and Maternal Folate Intake among Pregnancies Conceived after Folic Acid Fortification in the United States

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Citation

Mosley, Bridget S.; Cleves, Mario A.; Siega-Riz, Anna Maria; Shaw, Gary M.; Canfield, Mark A.; Waller, D. Kim; Werler, Martha M.; & Hobbs, Charlotte A., for the National Birth Defects Prevention Study (2009). Neural Tube Defects and Maternal Folate Intake among Pregnancies Conceived after Folic Acid Fortification in the United States. American Journal of Epidemiology, 169(1), 9-17. PMCID: PMC3139973

Abstract

Rates of neural tube defects have decreased since folic acid fortification of the food supply in the United States. The authors' objective was to evaluate the associations between neural tube defects and maternal folic acid intake among pregnancies conceived after fortification. This is a multicenter, case-control study that uses data from the National Birth Defects Prevention Study, 1998-2003. Logistic regression was used to compute crude and adjusted odds ratios between cases and controls assessing maternal periconceptional use of folic acid and intake of dietary folic acid. Among 180 anencephalic cases, 385 spina bifida cases, and 3, 963 controls, 21.1%, 25.2%, and 26.1%, respectively, reported periconceptional use of folic acid supplements. Periconceptional supplement use did not reduce the risk of having a pregnancy affected by a neural tube defect. Maternal intake of dietary folate was not significantly associated with neural tube defects. In this study conducted among pregnancies conceived after mandatory folic acid fortification, the authors found little evidence of an association between neural tube defects and maternal folic acid intake. A possible explanation is that folic acid fortification reduced the occurrence of folic acid-sensitive neural tube defects. Further investigation is warranted to possibly identify women who remain at increased risk of preventable neural tube defects.

URL

http://dx.doi.org/10.1093/aje/kwn331

Reference Type

Journal Article

Year Published

2009

Journal Title

American Journal of Epidemiology

Author(s)

Mosley, Bridget S.
Cleves, Mario A.
Siega-Riz, Anna Maria
Shaw, Gary M.
Canfield, Mark A.
Waller, D. Kim
Werler, Martha M.
Hobbs, Charlotte A., for the National Birth Defects Prevention Study

PMCID

PMC3139973

ORCiD

Siega-Riz - 0000-0002-1303-4248