Folates and Prevention of Neural-Tube Diseases

Abstract

Neural tube defects (NTDs) are congenital malformations of the brain and spinal cord caused by failure of the neural tube to close between 21 and 28 days following conception. Each year almost 400.000 infants are born with NTDs all over the world. Although many advances have been made in the spina bifida’s treatment and have led to an increased life expectancy and an improved life quality, no treatment exists that will completely eliminate the serious disability or premature mortality associated with it. For such a reason, reducing the risk of NTDs is an important goal. It is widely ac-cepted that adequate maternal consumption of folic acid before pregnancy and during the early weeks of gestation can reduce the danger of having a child with a neural tube defect (NTD). As a result, public health authorities worldwide have recommended consuming 400 μg folic acid per day during the periconceptional period in order to decrease the risk of first occurrence NTDs . This recommended dose is based mainly on the amount of folic acid associated with a reduction in NTDs in the majority of epidemiological studies. Literature data asserts that folic acid can prevent about 70% of NTD conceptions while folic acid-containing multivitamin can prevent about 90%; the diagnostic efficacy of ultrasound is nearly 100% in anencephalic fetuses and about 80% in fetuses with different manifestations of spina bifida. A bibliographical research regarding folate and NTD prevention, between 1988 and 2012, was done. The words used for Literature research were: Folic Acid, Spina bifida, Neural Tube Defects, Malformations. Search engines employed were: Medline, Pubmed, PopLine and the most relevant reports on the topic.