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Báo cáo y học: "The primary prevention of birth defects: Multivitamins or folic acid"

Tuyển tập các báo cáo nghiên cứu khoa học ngành y học tạp chí Medical Sciences dành cho các bạn sinh viên ngành y tham khảo đề tài: The primary prevention of birth defects: Multivitamins or folic acid? | Int. J. Med. Sci. 2004 1 1 50-61 50 Research paper Received 2004.2.25 Accepted 2004.3.17 Published 2004.3.20 Abstract Key words Author biography Corresponding address International Journal of Medical Sciences ISSN 1449-1907 www.medsci.org 2004 1 1 50-61 2004 Ivyspring International Publisher. All rights reserved The primary prevention of birth defects Multivitamins or folic acid Andrew E. Czeizel Foundation for the Community Control of Hereditary Diseases 1148 Budapest Bolgárkerék u. 3. Hungary Periconceptional use of folic acid alone or in multivitamin supplements is effective for the primary prevention of neural-tube defects. The Hungarian randomized and two-cohort controlled trials showed that periconceptional multivitamin supplementation can reduce the occurrence of some other structural birth defects i.e. congenital abnormalities. These findings were supported by many but not all observational studies. Recently there have been two main debated questions. The first one is whether the use of folic acid alone or folic acidcontaining multivitamins is better. The second one is connected with the dilemma of whether high dose of folic acid e.g. 5 mg might be better than a daily multivitamin with 0.4 - 0.8 mg of folic acid. Comparison of the pooled data of two Hungarian trials using a multivitamin containing 0.8 mg folic acid and the data of the Hungarian Case-Control Surveillance of Congenital Abnormalities using high dose of folic acid seemed to be appropriate to answer these questions. Multivitamins containing 0.4 -0.8 mg of folic acid were more effective for the reduction of neural-tube defects than high dose of folic acid. Both multivitamins and folic acid can prevent some part of congenital cardiovascular malformations. Only multivitamins were able to reduce the prevalence at birth of obstructive defects of urinary tract limb deficiencies and congenital pyloric stenosis. However folic acid was effective in preventing some part of rectal anal stenosis atresia and