A E Czeizel1. 1. Department of Human Genetics and Teratology, National Institute of Public Health-WHO Collaborating Centre for the Community Control of Hereditary Diseases, OKI, Budapest, Hungary.
Abstract
OBJECTIVE: A summary about the final results of the Hungarian double-blind placebo controlled randomised trial of periconceptional folic acid containing multivitamin and trace element supplementation. RESULTS: The major finding is a significant prevention of the first occurrence of neural-tube defect, urinary tract and cardiovascular defects, in addition a decrease in the rate of limb deficiencies and congenital hypertrophic pyloric stenosis. Fertility was slightly improved and the rate of twins increased significantly after periconceptional multivitamin supplementation. The effect of multivitamin supplementation for fetal death is controversial, but in general there is no clinically significant change. Periconceptional multivitamin supplementation can reduce the occurrence of nausea and vomiting. PRACTICAL IMPLEMENTATIONS: Consumption of foods which are rich in folate may not be the best way to prevent neural-tube defects and other congenital abnormalities. Periconceptional multivitamin supplementation is part of the periconceptional care in Hungary and it is an appropriate forum for the practical delivery for this primary prevention action. However, as a large proportion of pregnancies are unplanned, the widespread use of bread fortified with folic acid, vitamin B12 and B6 may decrease a considerable part of neural-tube defects and some other congenital abnormalities, in addition to vascular diseases due to hyperhomocysteinemia.
RCT Entities:
OBJECTIVE: A summary about the final results of the Hungarian double-blind placebo controlled randomised trial of periconceptional folic acid containing multivitamin and trace element supplementation. RESULTS: The major finding is a significant prevention of the first occurrence of neural-tube defect, urinary tract and cardiovascular defects, in addition a decrease in the rate of limb deficiencies and congenital hypertrophic pyloric stenosis. Fertility was slightly improved and the rate of twins increased significantly after periconceptional multivitamin supplementation. The effect of multivitamin supplementation for fetal death is controversial, but in general there is no clinically significant change. Periconceptional multivitamin supplementation can reduce the occurrence of nausea and vomiting. PRACTICAL IMPLEMENTATIONS: Consumption of foods which are rich in folate may not be the best way to prevent neural-tube defects and other congenital abnormalities. Periconceptional multivitamin supplementation is part of the periconceptional care in Hungary and it is an appropriate forum for the practical delivery for this primary prevention action. However, as a large proportion of pregnancies are unplanned, the widespread use of bread fortified with folic acid, vitamin B12 and B6 may decrease a considerable part of neural-tube defects and some other congenital abnormalities, in addition to vascular diseases due to hyperhomocysteinemia.
Authors: Teun van der Bom; A Carla Zomer; Aeilko H Zwinderman; Folkert J Meijboom; Berto J Bouma; Barbara J M Mulder Journal: Nat Rev Cardiol Date: 2010-11-02 Impact factor: 32.419
Authors: Carolyn M Summers; Laura E Mitchell; Anna Stanislawska-Sachadyn; Shirley F Baido; Ian A Blair; Joan M Von Feldt; Alexander S Whitehead Journal: Birth Defects Res A Clin Mol Teratol Date: 2010-08
Authors: Wendy N Nembhard; Xinyu Tang; Jingyun Li; Stewart L MacLeod; Joseph Levy; Gerald B Schaefer; Charlotte A Hobbs Journal: Am J Med Genet A Date: 2018-02-05 Impact factor: 2.802
Authors: Anna M Rozendaal; Anthonie J van Essen; Gerard J te Meerman; Marian K Bakker; Jan J van der Biezen; Sieneke M Goorhuis-Brouwer; Christl Vermeij-Keers; Hermien E K de Walle Journal: Eur J Epidemiol Date: 2013-10-04 Impact factor: 8.082