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Folic Acid: CDC Assistance
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A Call to Action | Birth Defect Surveillance Systems | Prevention Services | Epidemiologic Assistance | Requesting Assistance

The Prevention and Health Communications Section of the Birth Defects and Pediatric Genetics Branch* assists state and local health agencies, nonprofit organizations, and others with their efforts to prevent the occurrence of neural tube defects. We offer technical consultative services for:

  • Surveillance systems.

  • Prevention programs.

  • Epidemiologic investigations.


A Call To Action

The results of numerous studies have shown that folic acid, a B vitamin, is important in preventing NTDs. The Public Health Service estimates that half of all NTD-affected pregnancies could be prevented if all women of childbearing age consumed 0.4 mg. of folic acid per day.

Although the specific mechanism of how this preventive action occurs is not known, the scientific evidence is overwhelmingly convincing and is the basis for the following U.S. Public Health Service recommendation:

"All women of childbearing age in the United States who are capable of becoming pregnant should consume 0.4 mg of folic acid per day for the purpose of reducing their risk of having a pregnancy affected with spina bifida or other NTDs.

Because the effects of high intakes are not well known but include complicating the diagnosis of vitamin B12 deficiency, care should be taken to keep total folate consumption at less than 1.0 mg per day, except under the supervision of a physician.

Women who have had a prior NTD-affected pregnancy are at high risk of having a subsequent affected pregnancy. When these women are planning to become pregnant, they should consult their physicians for advice."

To prevent NTDs, we need to establish programs that encourage women to consume appropriate amounts of folic acid. To effectively encourage women to follow the PHS recommendation and to accurately monitor NTD rates and rates of folic acid consumption, states need to seriously consider conducting birth defects surveillance and providing birth defect prevention advice.

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Birth Defect Surveillance Systems

It is essential to improve surveillance for NTDs so that we can have accurate prevalence rates, evaluate prevention activities, and respond with public health action in a timely and effective manner. Accurate surveillance of pregnancies affected by neural tube defects is challenging because many cases do not come to term. To improve surveillance methods, we are working closely with several states.

We can help local and state health departments, universities, and other public sector agencies develop and evaluate birth defects surveillance systems. We provide expert consultation for 

  • System design and personnel training.

  • Data management and resource utilization.

  • Quality assurance and system evaluation.

The Metropolitan Atlanta Congenital Defects Program, managed by CDC, provides information on NTDs among live-born and stillborn infants and serves as a model for other surveillance systems. We continually try to improve these programs by incorporating emerging scientific findings, adopting new technologies, and testing innovative methods.

National Birth Defect Prevention Network

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Prevention Services

To prevent NTDs through women's daily consumption of 0.4 mg of folic acid, public and private institutions in the fields of health, nutrition, and food supply must work together at federal, state, and community levels.

We can help agencies and organizations develop and evaluate a neural tube defects prevention program. Our goals include:

  • Providing all women of child-bearing age access to dietary folate and folic acid.

  • Identifying risk factors for NTD-affected pregnancies.

  • Educating health care professionals and the public about the risk for NTDs and how to minimize that risk.

  • Promoting the consumption of folic acid by women of childbearing age.

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Epidemiologic Assistance

We know that the daily consumption of 0.4 mg of folic acid by women of childbearing age can prevent 50% to 70% of all cases of NTDs. We also know that there are other risk factors for NTDs such taking valproic acid, an anti-seizure drug during early pregnancy.

To discover unknown causes of NTDs and to increase scientific knowledge about NTDs, we are available to assist in conducting epidemiologic studies and investigations. This assistance may range from brief telephone or on-site collaborative arrangements. We offer several types of technical assistance:

  • Information about current scientific research and findings.

  • Assistance with study design.

  • Assistance with data analysis and interpretation.

We have extensive experience conducting epidemiologic research, including descriptive studies, etiologic studies, and hypothesis testing. Listed below are some studies of NTDs in which we have been involved:

  • Maternal fever and neural tube defects.

  • Etiologic heterogeneity of neural tube defects.

  • Periconceptional use of multivitamins and the occurrence of neural tube defects.

  • Investigation of a clusters of neural tube defects.

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Requesting Assistance

We also seek to promote ways of giving people accurate and timely information about NTDs. We respond to requests for information from state and local agencies, health professionals, universities, and the general public.

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· Overview   · What's New
· Recommendations · CDC Assistance
· Become Involved   · Materials and References

Date: January 24, 2007
Content source: National Center on Birth Defects and Developmental Disabilities

 

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