Low incidence of congenital neural tube defects at the Neiva University Hospital: possible effect of folic acid supplementation

Abstract

Neural tube defects (NTD) are brain or spinal cord congenital defects, causing death or severe disability Causes of NTDs are unknown. It seems that NTDs occur due to environ mental and genetic interactions. ln 1997, a significant increase in the rate of NTDs (p=0.035) related to 1996 was observed in the maternity wing at the University Hospital in Neiva, Colombia. Health authorities initiated a program according to the universal recommendation about folic acid supplementation and fortification to prevent NTDs (CDC Folic Acid Resource Guide). The aim of this study was to measure the incidence of NTDs in 1998, related to previous years, as a possible way to measure the impact of the actions adopted by the community and health authorities. The incidence of NTDs, Down syndrome, cleft or palate lip, stillbirth and fetal losses, was measured for 1998. The rate of NTDs was similar compared to that of Latin America (p=0.526), but significantly less than that for 1997 (p=0.024), and reached similar values than those of 1996 (p=0.807). The explanation for this reduction of NTDs is not clear now, but we conclude that there is an apparent impact of advice on preconceptional folic acid supplementation together with improvement in dietary intake through grain and flour fortification. We recommend to evaluate the attitudes and practices of childbearing women regarding the benefits of folic acid before conception and during pregnancy. It is also important to continue the surveillance program for NTDs.