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:
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
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System design and personnel training.
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Data management and resource utilization.
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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:
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Providing all women of child-bearing age access to
dietary folate and folic acid.
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Identifying risk factors for NTD-affected
pregnancies.
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Educating health care professionals and the public
about the risk for NTDs and how to minimize that risk.
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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:
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Information about current scientific research and
findings.
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Assistance with study design.
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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:
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Maternal fever and neural tube defects.
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Etiologic heterogeneity of neural tube defects.
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Periconceptional use of multivitamins and the
occurrence of neural tube defects.
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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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Date:
January 24, 2007
Content source: National Center on Birth Defects and Developmental
Disabilities
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