Abstract
Objective: Folic acid supplementation of breads and grains was implemented in the United States in 1998 to try to reduce the incidence of neural tube defects (NTDs). Complete birth registry outcome data will take several years to accumulate. Here we sought to use high maternal serum alpha-fetoprotein (MSAFP) values as a surrogate for likelihood of NTDs, both before and after folic acid supplementation. Methods: From 1997 and 2000, 61,119 AFP values were assessed for MOM at Quest Diagnostics Laboratory, Teterboro, NJ. Patients were characterized by MOM value. Results: Comparative data show a 42% decrease of patients with MOMs of 3.00+ (1.7% –1.33%). Further categorization revealed similar decreases. n ≤2.75 2.76–4.00 4.00+ n % n % n % 1997 27,020 26,330 97.4 488 1.80 202 0.75 2000 34,099 33,511 98.3 409 1.20 179 0.52 % decrease 61,119 59,841 — 897 33% 381 30% Conclusions: The introduction of folic acid supplementation has produced a profound decrease in the number of high AFPs, reflective of a decreased incidence of NTDs. This represents a highly successful public health policy for birth defect prevention.
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