Primary prevention of neural-tube defects and some other congenital abnormalities by folic acid and multivitamins: History, missed opportunity and tasks

  • Czeizel A
  • Bártfai Z
  • Bánhidy F
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Abstract

The history of intervention trials of periconception folic acid with multivitamin and folic acid supplementation in women has shown a recent breakthrough in the primary prevention of structural birth defects, namely neural-tube defects and some other congenital abnormalities. Recently, some studies have demonstrated the efficacy of this new method in reducing congenital abnormalities with specific origin; for example, in the offspring of diabetic and epileptic mothers, and in pregnancy with high fever. The benefits and drawbacks of four possible uses of periconception folate/folic acid and multivitamin supplementation are discussed: we believe there has been a missed opportunity to implement this preventive approach in medical practice. The four methods are as follows: (i) dietary intake of folate and other vitamins, (ii) periconception folic acid/multivitamin supplementation, (iii) food fortification with folic acid, and (iv) the combination of oral contraceptives with 6S-5-methytetrahydrofolate ('folate').

Author-supplied keywords

  • cardiovascular malformations
  • contraception
  • folic acid
  • multivitamins
  • neural-tube defects
  • prevention

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Authors

  • Andrew E. Czeizel

  • Zoltán Bártfai

  • Ferenc Bánhidy

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