Aggiornamento
L’assunzione periconcezionale di acido folico
THE PREVENTIVE EFFICACY OF THE PERICONCEPTIONAL USE OF FOLIC A
RENATA BORTOLUS
Ginecologa, ULSS 6 di Vicenza
Dicembre 2003 - pagg. 645 -650
Abstract
The preventive efficacy of the periconceptional use of folic acid is well established for neural
tube defects. Similar but lower protective effects have been suggested for other congenital
malformations such as orofacial clefts and some heart defects. This support the recommendation
that all women planning or at risk of pregnancy take a daily multivitamin supplement
containing folic acid, beginning one month before conception and continuing through the first
trimester for prevention of neural tube defects and other congenital malformations. Despite
this consistent evidence, in Italy no folate strategy of supplementation before conception or
food fortification has been developed. Recently an intervention project started also in Italy, in
order to evaluate the efficacy of a national preventive campaign on parents’ behaviour.
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1. MRC Vitamin Study Research Group. Prevention
of neural tube defects: results of the
MRC Vitamin Study. Lancet 1991;338:131-7.
2. Czeizel AE, Dudas I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med 1992 327:1832-5.
3. Lumley J, Watson L, Watson M, Bower C. Periconceptional supplementation with folate and/or multivitamins for preventing neural tube defects (Cochrane Review). In: The Cochrane Library, Issue 1, 2003. Oxford: Update Software.
4. Berry RJ, Li Z, Erickson JD, Li S, et al, for the China-US Collaborative Project for Neural Tube Defect Prevention. Prevention of neuraltube defects with folic acid in China. N Engl J Med 1999;341:1485-90.
5. Werler MM, Hayes C, Louik C, Shapiro S, Mitchell AA. Multivitamin supplementation and risk of birth defects. Am J Epidemiol 1999; 150:675-82.
6. Botto LD, Mulinare J, Erickson JD. Occurrence of congenital heart defects in relation to maternal multivitamin use. Am J Epidemiol 2000;151:878-84.
7. Hernandez-Diaz S, Werler MM, Walker AM, Mitchell AA. Folic acid antagonists during pregnancy and the risk of birth defects. N Engl J Med 2000;343:1608-14.
8. Myers MF, Li S, Correa-Villasenor A, et al, for the China-US Collaborative Project for Neural Tube Defect Prevention. Folic acid supplementation and risk for imperforate anus in China. Am J Epidemiol 2001;154:1051-6.
9. Botto LD, Mulinare J, Erickson JD. Occurrence of omphalocele in relation to maternal multivitamin use: a population-based study. Pediatrics 2002;109:904-8.
10. Thompson JR, Fitz GP, Willoughby MLN, Armstrong BK. Maternal folate supplementation in pregnancy and protection against leukaemia in childood: a case control study. Lancet 2001;358:1935-40.
11. French AE, Grant R, Weitzman S, et al. Folic acid food fortification is associated with a decline in neuroblastoma. Clin Pharmacol Ther 2003;74:288-94.
12. Barkai G, Arbuzova S, Berkenstadt M, et al. Frequency of Down’s syndrome and neuraltube defects in the same family. Lancet 2003; 361:1331-5.
13. Put NM van der, Thomas CM, Eskes TK, et al. Altered folate and vitamin B12 metabolism in families with spina bifida offspring. QJM 1997;90:505-10.
14. James SJ, Pogribna M, Pogribny IP, et al. Abnormal folate metabolism and mutation in the methylenetetrahydrofolate reductase gene may be maternal risk factors for Down syndrome. Am J Clin Nutr 1999;70:495-501.
15. Botto LD, Yang Q. 5,10-Methylenetetrahydrofolate reductase gene variants and congenital anomalies: a HuGE review. Am J Epidemiol 2000;151:862-77.
16. O’Leary VB, Parle-McDermott A, Molloy AM, et al. MTRR and MTHFR polymorphism: link to Down syndrome? Am J Med Genet 2002;107:151-5.
17. Expert Advisory Group. Folic Acid and the Prevention of Neural Tube Defects. London, England: Department of Health, 1992.
18. Centers for Disease Control. Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects. MMWR 1992;41:1-7.
19. Mastroiacovo P, Tamburlini G, per il Gruppo di lavoro prevenzione primaria del bambino. Sviluppo e valutazione di interventi di prevenzione primaria nel campo della salute infantile. Medico e Bambino 2000;5:306-9.
20. Wald NJ, Law MR, Morris JK, Wald DS. Quantifying the effect of folic acid. Lancet 2001;358:2069-73.
21. Holmes-Siedle M, Dennis J, Lindenbaum RH, Galliard A. Long term effects of periconceptional multivitamin supplements for prevention of neural tube defects: a seven to 10 year follow up. Arch Dis Child 1992;67:1436- 41.
22. Dobň M, Czeizel A. Long term follow up of children born to mothers with periconceptional multivitamin supplementation. Arch Dis Child 1997;77:183.
23. Lumley J, Watson L, Watson M, Bower C. Modelling the potential impact of populationwide periconceptional folate/multivitamin supplementation on multiple births. Br J Obstet Gynaecol 2001;108:937-42.
24. Li Z, Gindler J, Wang H, et al. Folic acid supplements during early pregnancy and likelihood of multiple births: a population-based cohort study. Lancet 2003;361:380-4.
25. Honein MA, Paulozzi LJ, Mathews TJ, et al. Impact of folic acid fortification of the US food supply on the occurrence of neural tube defects. JAMA 2001;285: 2981-6.
26. Ray JG, Meier C, Vermeulen MJ, et al. Association of neural tube defects and folic acid food fortification in Canada. Lancet 2002;360: 2047-8.
27. Castilla EE, Orioli IM, Lopez-Camelo JS, et al. Preliminary data on changes in neural tube defect prevalence rates after folic acid fortification in South America. Am J Med Genet 2003;123A:123-8.
28. Pal de Bruin KM van der, de Walle HEK, Jeeninga W, et al. The Dutch “Folic Acid Campaign” - have the goals been achieved? Paediatr Perinat Epidemiol 2000;14:111-7.
29. Johnston RB, Staples DA. Use of folic acid containing supplements among women of childbearing age. United States 1997. MMWR 1998;47:131-4.
30. CDC. Folic acid campaign and evaluation- Southwestern Virginia, 1997-1999. MMWR 1999;48:914-7.
31. Chan A, Pickering J, Haan EA, et al. ‘Folate before pregnancy’: The impact on women and health professionals of a population-based health promotion campaign in South Australia. Med J Aust 2001;174:631-6.
32. Bortolus R, Parazzini F, Addis A. Periconceptional folic acid supplements in Italy: evidence based clinical practice is possible? BMJ, 28 Jan 2000.
33. Annona C, Bortolus R, Carlucci N, et al. (Gruppo di Lavoro “Conoscere per Prevenire”). Sviluppo e valutazione di interventi di prevenzione primaria nel campo della salute infantile. Progetto finalizzato dal Ministero della Salute. Materiale informativo per gli operatori sanitari, 2002.
34. Pepe F, Pepe P, Grillo S, Insolia G. Assunzione periconcezionale di acido folico in coppie siciliane a rischio di ricorrenza di DTN. Minerva Ginecol 1999;51:s399-401.
2. Czeizel AE, Dudas I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med 1992 327:1832-5.
3. Lumley J, Watson L, Watson M, Bower C. Periconceptional supplementation with folate and/or multivitamins for preventing neural tube defects (Cochrane Review). In: The Cochrane Library, Issue 1, 2003. Oxford: Update Software.
4. Berry RJ, Li Z, Erickson JD, Li S, et al, for the China-US Collaborative Project for Neural Tube Defect Prevention. Prevention of neuraltube defects with folic acid in China. N Engl J Med 1999;341:1485-90.
5. Werler MM, Hayes C, Louik C, Shapiro S, Mitchell AA. Multivitamin supplementation and risk of birth defects. Am J Epidemiol 1999; 150:675-82.
6. Botto LD, Mulinare J, Erickson JD. Occurrence of congenital heart defects in relation to maternal multivitamin use. Am J Epidemiol 2000;151:878-84.
7. Hernandez-Diaz S, Werler MM, Walker AM, Mitchell AA. Folic acid antagonists during pregnancy and the risk of birth defects. N Engl J Med 2000;343:1608-14.
8. Myers MF, Li S, Correa-Villasenor A, et al, for the China-US Collaborative Project for Neural Tube Defect Prevention. Folic acid supplementation and risk for imperforate anus in China. Am J Epidemiol 2001;154:1051-6.
9. Botto LD, Mulinare J, Erickson JD. Occurrence of omphalocele in relation to maternal multivitamin use: a population-based study. Pediatrics 2002;109:904-8.
10. Thompson JR, Fitz GP, Willoughby MLN, Armstrong BK. Maternal folate supplementation in pregnancy and protection against leukaemia in childood: a case control study. Lancet 2001;358:1935-40.
11. French AE, Grant R, Weitzman S, et al. Folic acid food fortification is associated with a decline in neuroblastoma. Clin Pharmacol Ther 2003;74:288-94.
12. Barkai G, Arbuzova S, Berkenstadt M, et al. Frequency of Down’s syndrome and neuraltube defects in the same family. Lancet 2003; 361:1331-5.
13. Put NM van der, Thomas CM, Eskes TK, et al. Altered folate and vitamin B12 metabolism in families with spina bifida offspring. QJM 1997;90:505-10.
14. James SJ, Pogribna M, Pogribny IP, et al. Abnormal folate metabolism and mutation in the methylenetetrahydrofolate reductase gene may be maternal risk factors for Down syndrome. Am J Clin Nutr 1999;70:495-501.
15. Botto LD, Yang Q. 5,10-Methylenetetrahydrofolate reductase gene variants and congenital anomalies: a HuGE review. Am J Epidemiol 2000;151:862-77.
16. O’Leary VB, Parle-McDermott A, Molloy AM, et al. MTRR and MTHFR polymorphism: link to Down syndrome? Am J Med Genet 2002;107:151-5.
17. Expert Advisory Group. Folic Acid and the Prevention of Neural Tube Defects. London, England: Department of Health, 1992.
18. Centers for Disease Control. Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects. MMWR 1992;41:1-7.
19. Mastroiacovo P, Tamburlini G, per il Gruppo di lavoro prevenzione primaria del bambino. Sviluppo e valutazione di interventi di prevenzione primaria nel campo della salute infantile. Medico e Bambino 2000;5:306-9.
20. Wald NJ, Law MR, Morris JK, Wald DS. Quantifying the effect of folic acid. Lancet 2001;358:2069-73.
21. Holmes-Siedle M, Dennis J, Lindenbaum RH, Galliard A. Long term effects of periconceptional multivitamin supplements for prevention of neural tube defects: a seven to 10 year follow up. Arch Dis Child 1992;67:1436- 41.
22. Dobň M, Czeizel A. Long term follow up of children born to mothers with periconceptional multivitamin supplementation. Arch Dis Child 1997;77:183.
23. Lumley J, Watson L, Watson M, Bower C. Modelling the potential impact of populationwide periconceptional folate/multivitamin supplementation on multiple births. Br J Obstet Gynaecol 2001;108:937-42.
24. Li Z, Gindler J, Wang H, et al. Folic acid supplements during early pregnancy and likelihood of multiple births: a population-based cohort study. Lancet 2003;361:380-4.
25. Honein MA, Paulozzi LJ, Mathews TJ, et al. Impact of folic acid fortification of the US food supply on the occurrence of neural tube defects. JAMA 2001;285: 2981-6.
26. Ray JG, Meier C, Vermeulen MJ, et al. Association of neural tube defects and folic acid food fortification in Canada. Lancet 2002;360: 2047-8.
27. Castilla EE, Orioli IM, Lopez-Camelo JS, et al. Preliminary data on changes in neural tube defect prevalence rates after folic acid fortification in South America. Am J Med Genet 2003;123A:123-8.
28. Pal de Bruin KM van der, de Walle HEK, Jeeninga W, et al. The Dutch “Folic Acid Campaign” - have the goals been achieved? Paediatr Perinat Epidemiol 2000;14:111-7.
29. Johnston RB, Staples DA. Use of folic acid containing supplements among women of childbearing age. United States 1997. MMWR 1998;47:131-4.
30. CDC. Folic acid campaign and evaluation- Southwestern Virginia, 1997-1999. MMWR 1999;48:914-7.
31. Chan A, Pickering J, Haan EA, et al. ‘Folate before pregnancy’: The impact on women and health professionals of a population-based health promotion campaign in South Australia. Med J Aust 2001;174:631-6.
32. Bortolus R, Parazzini F, Addis A. Periconceptional folic acid supplements in Italy: evidence based clinical practice is possible? BMJ, 28 Jan 2000.
33. Annona C, Bortolus R, Carlucci N, et al. (Gruppo di Lavoro “Conoscere per Prevenire”). Sviluppo e valutazione di interventi di prevenzione primaria nel campo della salute infantile. Progetto finalizzato dal Ministero della Salute. Materiale informativo per gli operatori sanitari, 2002.
34. Pepe F, Pepe P, Grillo S, Insolia G. Assunzione periconcezionale di acido folico in coppie siciliane a rischio di ricorrenza di DTN. Minerva Ginecol 1999;51:s399-401.