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 journalArticlepeer-review

21 Citations (Scopus)


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
Issue number2
Publication statusPublished - 1 Jan 2008
Externally publishedYes


Dive into the research topics of 'Impact of folic acid food fortification on the birth prevalence of lipomyelomeningocele in Canada'. Together they form a unique fingerprint.

Cite this