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Review
. 2012:2012:295083.
doi: 10.1155/2012/295083. Epub 2012 Aug 5.

Periconceptional folate deficiency and implications in neural tube defects

J Safi  1 , L Joyeux, G E Chalouhi
Affiliations
Review

Periconceptional folate deficiency and implications in neural tube defects

J Safi et al. J Pregnancy. 2012.

Abstract

Nutritional deficiencies are preventable etiological and epigenetic factors causing congenital abnormalities, first cause of infant mortality. Folate deficiency has a well-established teratogenic effect, leading to an increasing risk of neural tube defects. This paper highlights the most recent medical literature about folate deficiency, be it maternal or paternal. It then focuses on associated deficiencies as nutritional deficiencies are multiple and interrelated. Observational and interventional studies have all been consistent with a 50-70% protective effect of adequate women consumption of folates on neural tube defects. Since strategies to modify women's dietary habits and vitamin use have achieved little progress, scientific as well as political effort is mandatory in order to implement global preventive public health strategies aimed at improving the alimentation of women in reproductive age, especially folic acid supplementation. Even with the recent breakthrough of fetal surgery for myelomeningocele, the emphasis should still be on prevention as the best practice rather than treatment of neural tube defects.

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Figures

Figure 1
Figure 1
Causes of human congenital abnormalities (adapted from [65]).
Figure 2
Figure 2
Combined etiopathogenesis of spina bifida (Shh: sonic hedgehog, Wnt: Wnt ligand in Wnt/β catenin signaling pathway, BMP: bone morphogenic protein, IGF: insulin-like growth hormone, and W: weeks) [66].
See this image and copyright information in PMC

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