Impact of folic acid food fortification on the birth prevalence of lipomyelomeningocele in Canada

Philippe De Wals, Margot I. Van Allen, R. Brian Lowry, Jane A. Evans, Michiel C. Van Den Hof, Marian Crowley, Fassiatou Tairou, Soo Hong Uh, Barbara Sibbald, Pamela Zimmer, Bridget Fernandez, Nora S. Lee, Théophile Niyonsenga

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

BACKGROUND: Recent studies reported no reduction in the frequency of lipomeningomyelocele (LMMC) in Hawaii and Nova Scotia after the implementation of a folic acid food fortification policy in 1998, while a marked reduction in the prevalence of other NTDs was observed. This study was performed to assess the prevalence of LMMC in Canada in relation to the timing of food fortification. METHODS: The study population included livebirths, stillbirths, and terminations of pregnancies because of fetal anomaly to women residing in seven Canadian provinces, from 1993 to 2002. In each province, the ascertainment of NTD cases relied on multiple sources, and in addition all medical charts were reviewed. The study period was divided into pre-, partial, and full fortification periods, based on results of red cell folate tests published in the literature. RESULTS: A total of 86 LMMC cases were recorded among approximately 1.9 million live births. The average birth prevalence rate was 0.05/1,000, ranging from a minimum of 0.01/1,000 in 2002 to a maximum of 0.08/1,000 in 1999. There was statistical heterogeneity between years (p = .01), but no pattern compatible with a decrease following fortification. Comparing the full fortification period with the prefortification period, there was a slight but not statistically significant decrease in LMMC birth prevalence. CONCLUSIONS: LMMC seems to be pathogenically distinct from myelomeningocele and more studies are needed to understand the embryologic mechanisms leading to this condition, and the environmental and genetic factors involved in its etiology.

Original languageEnglish
Pages (from-to)106-109
Number of pages4
JournalBirth Defects Research Part A - Clinical and Molecular Teratology
Volume82
Issue number2
DOIs
Publication statusPublished - 1 Jan 2008
Externally publishedYes

Fingerprint

Folic Acid
Canada
Parturition
Food
Nova Scotia
Meningomyelocele
Nutrition Policy
Stillbirth
Birth Rate
Live Birth
Pregnancy
Lipomyelomeningocele
Population

Cite this

De Wals, Philippe ; Van Allen, Margot I. ; Lowry, R. Brian ; Evans, Jane A. ; Van Den Hof, Michiel C. ; Crowley, Marian ; Tairou, Fassiatou ; Uh, Soo Hong ; Sibbald, Barbara ; Zimmer, Pamela ; Fernandez, Bridget ; Lee, Nora S. ; Niyonsenga, Théophile. / Impact of folic acid food fortification on the birth prevalence of lipomyelomeningocele in Canada. In: Birth Defects Research Part A - Clinical and Molecular Teratology. 2008 ; Vol. 82, No. 2. pp. 106-109.
@article{9b8a33512e4147f4998613c11760e4b1,
title = "Impact of folic acid food fortification on the birth prevalence of lipomyelomeningocele in Canada",
abstract = "BACKGROUND: Recent studies reported no reduction in the frequency of lipomeningomyelocele (LMMC) in Hawaii and Nova Scotia after the implementation of a folic acid food fortification policy in 1998, while a marked reduction in the prevalence of other NTDs was observed. This study was performed to assess the prevalence of LMMC in Canada in relation to the timing of food fortification. METHODS: The study population included livebirths, stillbirths, and terminations of pregnancies because of fetal anomaly to women residing in seven Canadian provinces, from 1993 to 2002. In each province, the ascertainment of NTD cases relied on multiple sources, and in addition all medical charts were reviewed. The study period was divided into pre-, partial, and full fortification periods, based on results of red cell folate tests published in the literature. RESULTS: A total of 86 LMMC cases were recorded among approximately 1.9 million live births. The average birth prevalence rate was 0.05/1,000, ranging from a minimum of 0.01/1,000 in 2002 to a maximum of 0.08/1,000 in 1999. There was statistical heterogeneity between years (p = .01), but no pattern compatible with a decrease following fortification. Comparing the full fortification period with the prefortification period, there was a slight but not statistically significant decrease in LMMC birth prevalence. CONCLUSIONS: LMMC seems to be pathogenically distinct from myelomeningocele and more studies are needed to understand the embryologic mechanisms leading to this condition, and the environmental and genetic factors involved in its etiology.",
keywords = "Folic acid, Food fortification, Lipoma, Myelocele",
author = "{De Wals}, Philippe and {Van Allen}, {Margot I.} and Lowry, {R. Brian} and Evans, {Jane A.} and {Van Den Hof}, {Michiel C.} and Marian Crowley and Fassiatou Tairou and Uh, {Soo Hong} and Barbara Sibbald and Pamela Zimmer and Bridget Fernandez and Lee, {Nora S.} and Th{\'e}ophile Niyonsenga",
year = "2008",
month = "1",
day = "1",
doi = "10.1002/bdra.20418",
language = "English",
volume = "82",
pages = "106--109",
journal = "Birth Defects Research Part A - Clinical and Molecular Teratology",
issn = "0040-3709",
publisher = "Wiley-Liss Inc.",
number = "2",

}

De Wals, P, Van Allen, MI, Lowry, RB, Evans, JA, Van Den Hof, MC, Crowley, M, Tairou, F, Uh, SH, Sibbald, B, Zimmer, P, Fernandez, B, Lee, NS & Niyonsenga, T 2008, 'Impact of folic acid food fortification on the birth prevalence of lipomyelomeningocele in Canada', Birth Defects Research Part A - Clinical and Molecular Teratology, vol. 82, no. 2, pp. 106-109. https://doi.org/10.1002/bdra.20418

Impact of folic acid food fortification on the birth prevalence of lipomyelomeningocele in Canada. / De Wals, Philippe; Van Allen, Margot I.; Lowry, R. Brian; Evans, Jane A.; Van Den Hof, Michiel C.; Crowley, Marian; Tairou, Fassiatou; Uh, Soo Hong; Sibbald, Barbara; Zimmer, Pamela; Fernandez, Bridget; Lee, Nora S.; Niyonsenga, Théophile.

In: Birth Defects Research Part A - Clinical and Molecular Teratology, Vol. 82, No. 2, 01.01.2008, p. 106-109.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of folic acid food fortification on the birth prevalence of lipomyelomeningocele in Canada

AU - De Wals, Philippe

AU - Van Allen, Margot I.

AU - Lowry, R. Brian

AU - Evans, Jane A.

AU - Van Den Hof, Michiel C.

AU - Crowley, Marian

AU - Tairou, Fassiatou

AU - Uh, Soo Hong

AU - Sibbald, Barbara

AU - Zimmer, Pamela

AU - Fernandez, Bridget

AU - Lee, Nora S.

AU - Niyonsenga, Théophile

PY - 2008/1/1

Y1 - 2008/1/1

N2 - BACKGROUND: Recent studies reported no reduction in the frequency of lipomeningomyelocele (LMMC) in Hawaii and Nova Scotia after the implementation of a folic acid food fortification policy in 1998, while a marked reduction in the prevalence of other NTDs was observed. This study was performed to assess the prevalence of LMMC in Canada in relation to the timing of food fortification. METHODS: The study population included livebirths, stillbirths, and terminations of pregnancies because of fetal anomaly to women residing in seven Canadian provinces, from 1993 to 2002. In each province, the ascertainment of NTD cases relied on multiple sources, and in addition all medical charts were reviewed. The study period was divided into pre-, partial, and full fortification periods, based on results of red cell folate tests published in the literature. RESULTS: A total of 86 LMMC cases were recorded among approximately 1.9 million live births. The average birth prevalence rate was 0.05/1,000, ranging from a minimum of 0.01/1,000 in 2002 to a maximum of 0.08/1,000 in 1999. There was statistical heterogeneity between years (p = .01), but no pattern compatible with a decrease following fortification. Comparing the full fortification period with the prefortification period, there was a slight but not statistically significant decrease in LMMC birth prevalence. CONCLUSIONS: LMMC seems to be pathogenically distinct from myelomeningocele and more studies are needed to understand the embryologic mechanisms leading to this condition, and the environmental and genetic factors involved in its etiology.

AB - BACKGROUND: Recent studies reported no reduction in the frequency of lipomeningomyelocele (LMMC) in Hawaii and Nova Scotia after the implementation of a folic acid food fortification policy in 1998, while a marked reduction in the prevalence of other NTDs was observed. This study was performed to assess the prevalence of LMMC in Canada in relation to the timing of food fortification. METHODS: The study population included livebirths, stillbirths, and terminations of pregnancies because of fetal anomaly to women residing in seven Canadian provinces, from 1993 to 2002. In each province, the ascertainment of NTD cases relied on multiple sources, and in addition all medical charts were reviewed. The study period was divided into pre-, partial, and full fortification periods, based on results of red cell folate tests published in the literature. RESULTS: A total of 86 LMMC cases were recorded among approximately 1.9 million live births. The average birth prevalence rate was 0.05/1,000, ranging from a minimum of 0.01/1,000 in 2002 to a maximum of 0.08/1,000 in 1999. There was statistical heterogeneity between years (p = .01), but no pattern compatible with a decrease following fortification. Comparing the full fortification period with the prefortification period, there was a slight but not statistically significant decrease in LMMC birth prevalence. CONCLUSIONS: LMMC seems to be pathogenically distinct from myelomeningocele and more studies are needed to understand the embryologic mechanisms leading to this condition, and the environmental and genetic factors involved in its etiology.

KW - Folic acid

KW - Food fortification

KW - Lipoma

KW - Myelocele

UR - http://www.scopus.com/inward/record.url?scp=40049088920&partnerID=8YFLogxK

U2 - 10.1002/bdra.20418

DO - 10.1002/bdra.20418

M3 - Article

VL - 82

SP - 106

EP - 109

JO - Birth Defects Research Part A - Clinical and Molecular Teratology

JF - Birth Defects Research Part A - Clinical and Molecular Teratology

SN - 0040-3709

IS - 2

ER -