Folates for reduction of risk of neural tube defects: using oral contraceptives as a source of folate

Anita L Nelson Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Harbor UCLA Medical Center, Torrance, CA, USA Abstract: The evidence that folates reduce the risk of neural tube defects (NTDs) is so compelling that supplementation has been recommended by every relevant authority. T...

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Main Author: Nelson AL
Format: Article
Language:English
Published: Dove Medical Press 2011-11-01
Series:Open Access Journal of Contraception
Online Access:http://www.dovepress.com/folates-for-reduction-of-risk-of-neural-tube-defects-using-oral-contra-a8614
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author Nelson AL
author_facet Nelson AL
author_sort Nelson AL
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description Anita L Nelson Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Harbor UCLA Medical Center, Torrance, CA, USA Abstract: The evidence that folates reduce the risk of neural tube defects (NTDs) is so compelling that supplementation has been recommended by every relevant authority. The Cochrane Database of Systematic Reviews has determined that folate supplementation should be rated as a Grade 1 recommendation. United States Preventive Health Services Task Force, the US Food and Drug Administration (FDA), and the Centers for Disease Control and Prevention (CDC) have all produced clear guidelines for such supplementation. Unfortunately, despite food fortification and targeted public health campaigns promoting folic acid supplementation, periconceptional utilization of folic acid supplements has decreased in the US in recent years. Worldwide, over 300,000 newborns are affected with NTDs every year. NTDs account for 10% of all neonatal mortality. This article will review the risk factors for NTDs and the evidence supporting folate supplementation. It will also describe the remaining problems and outline current ideas to solve them. Finally, new evidence of the effectiveness of adding metafolin to drospirenone-containing oral contraceptives in raising serum and red blood cell folate levels, the rationale for making such an addition, and an estimate of the magnitude of the contribution use of such pills might have on reducing NTDs will be discussed. Keywords: neural tube defects, folate, metafolin, oral contraceptives
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spelling doaj.art-4e9a6ee8c2e24064845fa6603b00e0312022-12-21T22:41:49ZengDove Medical PressOpen Access Journal of Contraception1179-15272011-11-012011default137150Folates for reduction of risk of neural tube defects: using oral contraceptives as a source of folateNelson ALAnita L Nelson Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Harbor UCLA Medical Center, Torrance, CA, USA Abstract: The evidence that folates reduce the risk of neural tube defects (NTDs) is so compelling that supplementation has been recommended by every relevant authority. The Cochrane Database of Systematic Reviews has determined that folate supplementation should be rated as a Grade 1 recommendation. United States Preventive Health Services Task Force, the US Food and Drug Administration (FDA), and the Centers for Disease Control and Prevention (CDC) have all produced clear guidelines for such supplementation. Unfortunately, despite food fortification and targeted public health campaigns promoting folic acid supplementation, periconceptional utilization of folic acid supplements has decreased in the US in recent years. Worldwide, over 300,000 newborns are affected with NTDs every year. NTDs account for 10% of all neonatal mortality. This article will review the risk factors for NTDs and the evidence supporting folate supplementation. It will also describe the remaining problems and outline current ideas to solve them. Finally, new evidence of the effectiveness of adding metafolin to drospirenone-containing oral contraceptives in raising serum and red blood cell folate levels, the rationale for making such an addition, and an estimate of the magnitude of the contribution use of such pills might have on reducing NTDs will be discussed. Keywords: neural tube defects, folate, metafolin, oral contraceptiveshttp://www.dovepress.com/folates-for-reduction-of-risk-of-neural-tube-defects-using-oral-contra-a8614
spellingShingle Nelson AL
Folates for reduction of risk of neural tube defects: using oral contraceptives as a source of folate
Open Access Journal of Contraception
title Folates for reduction of risk of neural tube defects: using oral contraceptives as a source of folate
title_full Folates for reduction of risk of neural tube defects: using oral contraceptives as a source of folate
title_fullStr Folates for reduction of risk of neural tube defects: using oral contraceptives as a source of folate
title_full_unstemmed Folates for reduction of risk of neural tube defects: using oral contraceptives as a source of folate
title_short Folates for reduction of risk of neural tube defects: using oral contraceptives as a source of folate
title_sort folates for reduction of risk of neural tube defects using oral contraceptives as a source of folate
url http://www.dovepress.com/folates-for-reduction-of-risk-of-neural-tube-defects-using-oral-contra-a8614
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