Role Of Folic Acid in the Prevention of Neural Tube Defects Flashcards
Congenital deformities that occur when the embryonic neural tube fails to completely close during its development
Neural tube defects
Incidence 1-5/1000 births
NTD is the 6th MC birth defect
Recommended daily intake of folic acid
0.4mg or 400mcg per day
Folic acid supplementation prior to and in the beginning of pregnancy dramatically reduced the risk of having an NTD-affected pregnancy
The neural tube usually closes within the first ___ to ___ days of life.
21 to 28 days
NTD vary in severity.
Mildest form =
Most severe form =
Mildest = spina bifida occulta Severe = anencephaly, rachischisis
Strategies to achieve adequate levels of folic acid include:
- increase intake of folate-rich food
- dietary folic acid supplementation
- folic acid fortification of food
Synthetic folic acid has better bioavailability
from food 50%
from fortified food 85%
vitamin supplements 100%
For those women with a previous NTD-affected pregnancies, a different regimen is followed. They are still to take daily the FA 0.4mg (400mcg) even if they dont have the intention of getting pregnant. However, if they plan another pregnancy, the recommendation is:
FA 4mg (4000mcg) supplementation daily at least 1 month prior to getting pregnant until the 1st 3 months of pregnancy.
The Philippines recognizes numerous nutritional deficiencies in the country including energy, vit A, iron, iodine, thiamine, riboflavin, ascorbic acid, calcium and folate. To compensate for the inadequacy of the Filipino diet based on the RDA, food fortification was introduced in the country through the passing of this law:
RA 8976 “The Philippine Food Fortification Act of 2000”
Mandatory food fortification in the country only covers which 3 vit/minerals:
Iron
Vitamin A
Iodine
Example of medications that interfere with folate utilization
Valproic acid
TMP-SMX
