The Japanese Teratology Society declares "Folic Acid Awareness Day" and "Neural Tube Defect Prevention Month".

Abstract

The Japanese Teratology Society (JTS) is sending an important message to Japanese people through the declaration of Folic Acid Awareness Day and Neural Tube Defect Prevention Month. The purpose of this statement is to prevent the occurrence of Neural Tube Defects (NTDs) as much as possible through folic acid supplementation1 prior to and during conception. Briefly, NTDs, such as myelomeningocele and anencephaly, are congenital anomalies involving defects in the brain and/or spinal cord that develop around gestation week 6 (4 weeks after fertilization). A randomized controlled trial from United Kingdom in 19912 and a cohort study from China in 19993 demonstrated that NTDs are partially folic acid-preventable and that periconceptional folic acid supplementation could decrease the occurrence or recurrence by 40% to 70%. In 2000, the Ministry of Health and Welfare of Japan recommended that women planning a pregnancy should take folic acid 0.4 mg daily, from 4 weeks prior to conception to 12 weeks of gestation.4 Risk factors of NTDs among Japanese women comprise of not taking folic acid supplements, presence of myelomeningocele in patients within third-degree relatives, use of anti-epileptic drugs without folic acid, and low birth weight in the newborn.5 In 2017, JTS stressed on importance of taking folic acid 0.4 mg daily for those who plan to conceive, in order to reduce the risk of NTDs in the developing fetus.6 During the past quarter of century, the prevalence of myelomeningocele has not declined, while that of anencephaly has significantly decreased because the majority of pregnancies involving such fetal defects were terminated. The low awareness rates of the role that folic acid plays in the pregnancy7 and the low rates of folic acid supplementation prior to getting pregnant8 account for the overall trend for a lack of NTD decline in Japan. Hence, the present communication is urgent and important for not only the Japanese people but also people living in countries without folic acid fortification. We have decided that 3 April will be considered Folic Acid Awareness Day, as the pronunciation of “folic acid” in Japanese (You Sann) is similar to that of “3 April” (Yonn Sann). Further, the whole month of April will be remembered as the Neural Tube Defect Prevention Month. It is hoped that through the commemoration of this day and month every year with the character representing folic acid (Figure 1), Japanese people will recognize the importance and necessity of taking folic acid supplementation prior to and during pregnancy.9 We urge those of other academic societies who read or hear of this notice to voice solidarity with our endeavor and co-operate with us by spreading information and educating people regarding the great benefits of folic acid.