Abstract
A comparison has been made of the effectiveness of periconceptional vitamin supplementation for the prevention of recurrence of neural tube defects (NTD) in south-east England and Northern Ireland. These areas represent the extremes of birth prevalence of NTD (low and high respectively) within the United Kingdom. Vitamin therapy resulted in a slightly less than two-fold reduction in the recurrence risk in south-east England and a greater than three-fold reduction in Northern Ireland, when compared with unsupplemented women at the same risk from the two areas. It is probable that one of the recurrences in each area did not involve the multifactorial form of NTD and, if these are excluded, then the reduction in recurrence risk with vitamin supplementation is 2.4 times in south-east England and 5.4 times in Northern Ireland. Either way, beneficial effects of supplementation are apparent in both areas but are more marked in the high prevalence area. The implications of this for the future are discussed. Two other important findings were that all but one of the recurrences of NTD with full supplementation occurred in male fetuses, and there was a higher than expected occurrence of isolated hydrocephalus in infants or fetuses following full supplementation.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Cohen T., Stern E., Rosenmann A. Sib risk of neural tube defect: is prenatal diagnosis indicated in pregnancies following the birth of a hydrocephalic child? J Med Genet. 1979 Feb;16(1):14–16. doi: 10.1136/jmg.16.1.14. [DOI] [PMC free article] [PubMed] [Google Scholar]
- James W. H. The sex ratio in anencephaly. J Med Genet. 1979 Apr;16(2):129–133. doi: 10.1136/jmg.16.2.129. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mills J. L. Malformations in infants of diabetic mothers. Teratology. 1982 Jun;25(3):385–394. doi: 10.1002/tera.1420250316. [DOI] [PubMed] [Google Scholar]
- PEDERSEN L. M., TYGSTRUP I., PEDERSEN J. CONGENITAL MALFORMATIONS IN NEWBORN INFANTS OF DIABETIC WOMEN. CORRELATION WITH MATERNAL DIABETIC VASCULAR COMPLICATIONS. Lancet. 1964 May 23;1(7343):1124–1126. doi: 10.1016/s0140-6736(64)91805-7. [DOI] [PubMed] [Google Scholar]
- Seller M. J. Cause of neural tube defects. J Med Genet. 1980 Dec;17(6):491–492. doi: 10.1136/jmg.17.6.491-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Seller M. J., Embury S., Polani P. E., Adinolfi M. Neural tube defects in curly-tail mice. II. Effect of maternal administration of vitamin A. Proc R Soc Lond B Biol Sci. 1979 Nov 30;206(1162):95–107. doi: 10.1098/rspb.1979.0093. [DOI] [PubMed] [Google Scholar]
- Seller M. J. Recurrence risks for neural tube defects in a genetic counseling clinic population. J Med Genet. 1981 Aug;18(4):245–248. doi: 10.1136/jmg.18.4.245. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sever L. E. An epidemiologic study of neural tube defects in Los Angeles County II. Etiologic factors in an area with low prevalence at birth. Teratology. 1982 Jun;25(3):323–334. doi: 10.1002/tera.1420250309. [DOI] [PubMed] [Google Scholar]
- Smithells R. W., Nevin N. C., Seller M. J., Sheppard S., Harris R., Read A. P., Fielding D. W., Walker S., Schorah C. J., Wild J. Further experience of vitamin supplementation for prevention of neural tube defect recurrences. Lancet. 1983 May 7;1(8332):1027–1031. doi: 10.1016/s0140-6736(83)92654-5. [DOI] [PubMed] [Google Scholar]
- Smithells R. W., Sheppard S., Schorah C. J., Seller M. J., Nevin N. C., Harris R., Read A. P., Fielding D. W. Apparent prevention of neural tube defects by periconceptional vitamin supplementation. Arch Dis Child. 1981 Dec;56(12):911–918. doi: 10.1136/adc.56.12.911. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Soler N. G., Walsh C. H., Malins J. M. Congenital malformations in infants of diabetic mothers. Q J Med. 1976 Apr;45(178):303–313. [PubMed] [Google Scholar]