Abstract
Neural tube defects are the most common type of congenital neurological defects that can lead to mortality, morbidity, and impaired quality of life in patients due to neural tube closure defects in early pregnancy.
Since 1991, several multicenter, randomized, controlled trials have demonstrated that preconceptional and periconceptional folic acid intake, folic acid fortification of foods, and targeted prenatal screening are crucial for primary and secondary prevention of neural tube defects.
Methods: This article reviews the current status of interventions that contribute to reducing the risk of neural tube defects by improving folate status in the population, including dietary diversification, supplementation, food fortification, and education in the world. Folic acid supplementation cannot guarantee 100% prevention of neural tube defects, as up to one-third of these defects are folate-resistant. Therefore, the focus is now on finding alternative prevention strategies and exploring new biomarkers using omics technologies supported by artificial intelligence.
Results: Mandatory food folate fortification, appropriate supplementation, improved infrastructure and access to antenatal care are factors that can lead to a global reduction in NTDs. This approach should emphasize education, outreach, national programs, and take into account regional access to health care or social determinants of health. The strategy requires coordination between multiple sectors, including governments, the food industry, health service providers and the education sector. Political and international cooperation between governmental and non-governmental organisations is also key (Ref. 74). Text in PDF www.lekarsky.herba.sk.
KEY WORDS: folic acid, prevention of neural tube defects, supplementation, food fortification, national programs, precision medicine, personalized medicine.
Lek Obz 2024, 73 (8): 296-303
Vanda RÍSOVÁ 1, Vladimír JAKUŠ 2, Lívia GAJDOŠOVÁ 2, Ladislav TURECKÝ 2, Petra OAPKOVÁ 3, Ján LÍŠKA 1, Štefan POLÁK 4
1 Ústav histológie a embryológie LF UK v Bratislave, prednosta prof. RNDr. I. Varga, PhD. et PhD.
2 Ústav lekárskej chémie, biochémie a klinickej biochémie LF UK v Bratislave, prednosta prof. MUDr. L. Turecký, CSc.
3 II. gynekologicko-pôrodnícka klinika LF UK a UN v Bratislave, prednosta prof. MUDr. J. Záhumenský, PhD, MPH
4 Anatomický ústav LF UK v Bratislave, prednosta prof. MUDr. Š. Polák, CSc.
