Gong Chen, Xinming Song, and Yang Ji contributed equally to this article.
Prevention of NTDs with periconceptional multivitamin supplementation containing folic acid in China
Article first published online: 16 JUL 2008
Copyright © 2008 Wiley-Liss, Inc.
Birth Defects Research Part A: Clinical and Molecular Teratology
Volume 82, Issue 8, pages 592–596, August 2008
How to Cite
Chen, G., Song, X., Ji, Y., Zhang, L., Pei, L., Chen, J., Liu, J., Li, C. and Zheng, X. (2008), Prevention of NTDs with periconceptional multivitamin supplementation containing folic acid in China. Birth Defects Research Part A: Clinical and Molecular Teratology, 82: 592–596. doi: 10.1002/bdra.20471
- Issue published online: 12 AUG 2008
- Article first published online: 16 JUL 2008
- Manuscript Accepted: 6 DEC 2007
- Manuscript Received: 22 OCT 2007
- National “973” project on Population and Health. Grant Number: 2007CB511901
- National Health Baby Promotion Program. Grant Number: FP2000NO13
- Education Ministry Key Program. Grant Number: 02185
- National Yang Zi Scholar Program
- 211 and 985 projects of Peking University. Grant Number: 20020903
- neural tube defects;
- periconceptional supplementation;
- multivitamin containing folic acid
BACKGROUND: Maternal nutritional factors seem to contribute substantially to the complex etiologies of NTDs. Foremost among these factors is the periconceptional use of supplementation containing folic acid, which is associated with a reduction in the risk of women having NTD-affected pregnancies. This study was designed to observe the effectiveness of multivitamin supplementation containing folic acid in preventing NTDs in a Chinese population and to detect factors that would impact the effectiveness. METHODS: Through family planning networks, a population-based community intervention study was carried out in 18 counties of China. Participants were divided into an intervention (taking multivitamin) group and a control group, and were followed up according to periconceptional multivitamin supplementation (in general 6 mg) for 2 years. Women who had a pregnancy were followed up from 28 weeks gestation at least to pregnancy termination, and the outcome was recorded. The incidence rate of the two groups and the relative risks were calculated to evaluate the efficacy of the multivitamin supplement in preventing NTDs. RESULTS: During 2000 and 2002, all of the women having pregnancies with birth defects and women whose pregnancies were without any birth defects were interviewed. Nine NTDs were recorded from 25,444 pregnancies (NTD birth prevalence = 0.35/1,000 pregnancies) in the intervention group and 48 NTDs among 26,599 pregnancies (NTD birth prevalence = 1.80/1,000 pregnancies) in the control group. The protective rate was 80.4%. CONCLUSIONS: Periconceptional multivitamin supplementation containing folic acid can prevent the occurrence of NTDs with the beneficial effect dependent on the frequency and timing of the supplementation. Our study suggests that multivitamin supplement containing folic acid taken from a time point of 2 months before conception and continuing until completion of the second month after conception and taken more than five times per week can significantly reduce the risks of NTDs. Birth Defects Research (Part A), 2008. © 2008 Wiley-Liss, Inc.