Changes in the birth prevalence of selected birth defects after grain fortification with folic acid in the United States : Findings from a multi-state population-based study

Mark A Canfield; Julianne S Collins; Lorenzo D Botto; Laura J Williams; Cara T Mai; Russell S Kirby; Kay Pearson; Owen Devine; Joe Mulinare; National Birth Defects Prevention Network

doi:10.1002/bdra.20210

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Changes in the birth prevalence of selected birth defects after grain fortification with folic acid in the United States : Findings from a multi-state population-based study

Journal article

Peer reviewed

Changes in the birth prevalence of selected birth defects after grain fortification with folic acid in the United States : Findings from a multi-state population-based study

Mark A Canfield, Julianne S Collins, Lorenzo D Botto, Laura J Williams, Cara T Mai, Russell S Kirby, Kay Pearson, Owen Devine, Joe Mulinare and National Birth Defects Prevention Network

Birth defects research. A Clinical and molecular teratology, Vol.73(10), pp.679-689

2005

DOI: 10.1002/bdra.20210

PMID: 16240378

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Abstract

Background: Observational studies and clinical trials have suggested that periconceptional use of folic acid can reduce the risk of birth defects other than neural tube defects (NTDs). Using data reported by states to the National Birth Defects Prevention Network, we examined whether folic acid fortification might have decreased the prevalence of other specific birth defects. Methods: For each of 16 birth defect categories selected for study, birth prevalence for two time periods was calculated with data submitted from a number of states in 1995-1996 ("pre-fortification") and 1999-2000 ("post-fortification"). Changes in birth prevalence between the two time periods were assessed by calculating prevalence ratios and 95% confidence intervals for each defect, and compared by maternal race/ethnicity and availability of prenatally diagnosed cases. Results: We confirmed previously reported reductions in the birth prevalence of NTDs. In addition, we found modest, yet statistically significant, decreases in the birth prevalence for transposition of the great arteries(12%), cleft palate only (12%), pyloric stenosis (5%), upper limb reduction defects (11%), and omphalocele (21%). More substantial subgroup decreases were observed for renal agenesis among programs that conduct prenatal surveillance (28%), for common truncus among Hispanics (45%), and for upper limb reduction defects among Hispanics (44%). There were modest yet significant increases in the prevalence of obstructive genitourinary defects (12%) and Down syndrome (7%), but not among programs conducting prenatal surveillance for these defects. Conclusions: These results suggest some modest benefit from the folic acid fortification on the prevalence of a number of non-NTD birth defects.

Biological and medical sciences

Embryology: invertebrates and vertebrates. Teratology

Fundamental and applied biological sciences. Psychology

Teratology. Teratogens

Details

Title: Subtitle: Changes in the birth prevalence of selected birth defects after grain fortification with folic acid in the United States : Findings from a multi-state population-based study
Creators: Mark A Canfield - Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX, United States
Julianne S Collins - JC Self Research Institute of Human Genetics, Greenwood Genetic Center, Greenwood, SC, United States
Lorenzo D Botto - National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
Laura J Williams - National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
Cara T Mai - National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
Russell S Kirby - Department of Maternal and Child Health, School of Public Health, University of Alabama at Birmingham, Birmingham AL, United States
Kay Pearson - Oklahoma State Department of Health, Oklahoma City, OK, United States
Owen Devine - National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
Joe Mulinare - National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
National Birth Defects Prevention Network
Contributors: Paul A Romitti (Contributor) - University of Iowa, Epidemiology
Resource Type: Journal article
Publication Details: Birth defects research. A Clinical and molecular teratology, Vol.73(10), pp.679-689
DOI: 10.1002/bdra.20210
PMID: 16240378
NLM abbreviation: Birth Defects Res A Clin Mol Teratol
ISSN: 1542-0752
eISSN: 1542-0760
Publisher: Wiley
Language: English
Date published: 2005
Academic Unit: Epidemiology; Biostatistics
Record Identifier: 9984214805602771

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