Impact of folic acid food fortification on the birth prevalence of lipomyelomeningocele in Canada
Article first published online: 29 NOV 2007
Copyright © 2007 Wiley-Liss, Inc.
Birth Defects Research Part A: Clinical and Molecular Teratology
Volume 82, Issue 2, pages 106–109, February 2008
How to Cite
De Wals, P., Van Allen, M. I., Lowry, R. B., Evans, J. A., Van den Hof, M. C., Crowley, M., Tairou, F., Uh, S.-H., Sibbald, B., Zimmer, P., Fernandez, B., Lee, N. S. and Niyonsenga, T. (2008), Impact of folic acid food fortification on the birth prevalence of lipomyelomeningocele in Canada. Birth Defects Research Part A: Clinical and Molecular Teratology, 82: 106–109. doi: 10.1002/bdra.20418
- Issue published online: 21 FEB 2008
- Article first published online: 29 NOV 2007
- Manuscript Accepted: 28 SEP 2007
- Manuscript Revised: 27 SEP 2007
- Manuscript Received: 18 JUL 2007
- folic acid;
- food fortification
BACKGROUND: Recent studies reported no reduction in the frequency of lipomeningomyelocele (LMMC) in Hawaii and Nova Scotia after the implementation of a folic acid food fortification policy in 1998, while a marked reduction in the prevalence of other NTDs was observed. This study was performed to assess the prevalence of LMMC in Canada in relation to the timing of food fortification. METHODS: The study population included livebirths, stillbirths, and terminations of pregnancies because of fetal anomaly to women residing in seven Canadian provinces, from 1993 to 2002. In each province, the ascertainment of NTD cases relied on multiple sources, and in addition all medical charts were reviewed. The study period was divided into pre-, partial, and full fortification periods, based on results of red cell folate tests published in the literature. RESULTS: A total of 86 LMMC cases were recorded among approximately 1.9 million live births. The average birth prevalence rate was 0.05/1,000, ranging from a minimum of 0.01/1,000 in 2002 to a maximum of 0.08/1,000 in 1999. There was statistical heterogeneity between years (p = .01), but no pattern compatible with a decrease following fortification. Comparing the full fortification period with the prefortification period, there was a slight but not statistically significant decrease in LMMC birth prevalence. CONCLUSIONS: LMMC seems to be pathogenically distinct from myelomeningocele and more studies are needed to understand the embryologic mechanisms leading to this condition, and the environmental and genetic factors involved in its etiology. Birth Defects Research (Part A), 2008. © 2007 Wiley-Liss, Inc.