Birth defects in Canada decrease with more folic acid

by Jeff Gelski
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WASHINGTON — Neural-tube defects recorded at birth decreased 46% from 1998 to 2002 in Canadian study results that appear in the July 12 issue of The New England Journal of Medicine. Researchers concluded food fortification with folic acid was associated with a significant reduction in the rate of neural-tube defects in Canada.

Folic acid fortification of a large variety of cereal products became mandatory in Canada in 1998. Researchers assessed changes in the prevalence of neural-tube defects in seven Canadian provinces from 1998 to 2002. Results included both before and after food fortification with folic acid was implemented. Dr. Philippe De Wals, a professor at Laval University in Quebec, led the research.

A total of 2,446 subjects with neural-tube defects were recorded among 1.9 million births. The prevalence of neural-tube defects decreased from 1.58 per 1,000 births before fortification to 0.86 per 1,000 births during a full-fortification period. The magnitude of the decrease was proportional to the pre-fortification baseline in each Canadian province. The observed reduction in rate was greater for spina bifida (a decrease of 53%) than for anencephaly (38%) and encephalocele (31%).

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