Abstract
Several studies reported that enriched cereal grains have been fortified with folic
acid to reduce the incidence of neural tube defects (NTDs). The present study was
done to evaluate the impact of flour fortification with folic acid on the prevalence
of NTDs in Northern Iran. In this hospital-based study conducted between March 2006
and September 2009, we screened all live births at 16 hospitals and therapeutic abortions
in legal centers in Golestan province of Northern Iran. The number of births, per
1000, affected by NTDs during the periods before (March 2006-June 2007), during (July
2007-March 2008) and after (May 2008-September 2009) folic acid fortification was
assessed. NTDs including anencephaly, encephalocele and spina bifida were defined
in accordance with the international classification of diseases, 10th revision (international
classification of diseases-10). A total of 126 subjects with NTDs were recorded among
live births (104,232) and therapeutic abortions (131) from March 2006 to September
2009. The prevalence of NTDs reduced from 1.78 per 1,000 births before fortification
(95% confidence interval: 1.36 to 2.28) to 0.84 per 1,000 after full fortification
(95% confidence interval: 0.60 to 1.14). The reduction rate of NTDs between before
and after fortification was 52.81%. This study showed that flour fortification with
folic acid is associated with a significant reduction in the rate of NTDs in Golestan
province of Northern Iran.
Keywords
Neural tube defects - folic acid - flour fortification - Iran
