| Abstract | dc.description.abstract | Background: In Chile, flour is fortified with folic acid since 2000,
and the incidence of neural tube defects has decreased. Cranio-encephalic congenital defects
(CECD) have a wider clinical scope, includind classical neural tube defects (NTD) such as
anencephalia and acrania, but also incorporating other defects. Therefore, the effects of folic acid
fortification on the incidence of CECD could be different. Aim: To study the effect of folic acid
fortification on the incidence of CECD. Material and methods: All prenatal diagnoses of CECD
and cases registered locally in the Latin American Collaborative Study of Congenital Malformations
(ECLAMC) were reviewed. The obtained data were crossed with all death certificates of newborns or
stillborns of more than 500 g in the Sixth Region, in Central Chile. All cases were classified again in
four subtypes, according to their phenotype. The incidences of all subtypes prior (1996-2000) and
after folic acid supplementation (2001-2004), were compared. Results: Between 1996 and 2004,
there were 64 cases of CEDC among 109,176 infants born alive. The global rate was 8.86 per 10,000
born alive in the period prior to fortification and 3.03 per 10,000 born alive after fortification.
Comparing both periods, there was a 66% reduction in all CECD and a 77 and 100% reduction in
subtypes A and B of CECD, respectively (p <0.05). No significant reductions in type C and D CECD,
were observed. Conclusions: After the start of flour folic acid fortification, there was a global
reduction in the incidence of CECD. However, only types A and B CECD, supposedly more responsive
to folic acid, were reduced | en |
