Recommendations For NTD-Neural Tube Defects NTDs Prevention

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SPINA BIFIDA - PREVENTIVE MEASURES

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Periconceptional Folic Acid Supplementation For Primary Prevention

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DR. SANTOSH KARMARKAR
Consultant Pediatric Surgeon, B. J. Wadia Children's Hospital.

Our Recommendations

To prevent occurrence of neural tube defects:

Extra folate / folic acid is recommended for all women prior to conception and during the first twelve weeks of pregnancy.
The three possible ways of achieving an extra intake of folate / folic acid (eating more folate rich foods, eating foods fortified with folic acid, taking folic acid as a medicinal / food supplement).
Women who are planning a pregnancy should eat more folate rich foods and avoid over cooking them.
The range of foodstuffs containing folic acid should be increased.
Fortification of foodstuffs should be restricted to limited foodstuffs.
There should continue to be a choice of unfortified foods.
All woman who are planning a pregnancy should be advised to take 0.4 milligrams (400 micrograms) folic as a daily medicinal or food supplement from when they begin trying to conceive until twelfth week of pregnancy.
Women who have not been supplementing their folate /folic acid intakes and who suspect they may be pregnant should start supplementation at once and continue until the twelfth week of pregnancy. Consideration should be given to making folic acid tablets or capsules available free of charge as pre - pregnancy supplement.
There should be major programmes for education for professional and for the lay public. There should be central co-ordination facility to monitor the prevalence of Neural tube defects both before antenatal diagnosis and at birth to determine changes in prevalence and to monitor for early warnings of the hazard.
Research should be undertaken on the mechanisms by which folate / folic acid prevents Neural Tube Defects.

Last created on 30-10-2001
Last updated on 01-07-2006

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