Europe has failed to implement effective policy to reduce risk of NTD by folic acid

November 26, 2015   World

International Federation for Spina Bifida and Hydrocephalus | Source

folic acid 1Brussels— The prevalence of neural tube defects (NTD) in Europe has not declined substantially in the past 20 years, despite long-standing recommendations for women to take folic acid supplements if planning a pregnancy,  is the main finding of a new study, published in the British Medical Journal (BMJ). Total prevalence remains ~9 per 10.000. According to Hermien de Walle from EUROCAT, this could be 5 per 10.000 with optimal use of folic acid.

Experts analysed data for more than 11,000 cases of neural tube defects from 28 EUROCAT registries covering approximately 12.5 million births in 19 countries between 1991 and 2011. 

A new study provides clear evidence of the efficacy of folic acid in preventing neural tube defects, the most common birth defect, affecting over 300.000 babies are born each day. Specifically, around 5.000 pregnancies in Europe are affected by neural tube defects. Every woman, especially those who want to become pregnant, needs to get 400 micrograms of folic acid every day.

Taking folic acid supplements before and during early pregnancy can greatly reduce the incidence of NTDs by up to 70% and mandatory folic acid fortification can reduce the incidence by an average of 46%.

Already in 2010, IF and Bayer HealthCare Pharmaceuticals published a joint report on the prevention of NTDs, "Act against Europe's most common birth defects: The right advice at the right time can reduce Neural Tube Defects now" that highlighted that the progress in reducing NTD incidence remained disappointing and called for a focus on addressing the unnecessarily high incidence of NTD affected pregnancies.

Globally, 80 countries have legislation to mandate folic acid fortification of at least one industrial milled cereal grain. In developed countries only Australia, U.S., Canada and Kosovo require mandatory grain fortification.

For example, in the US folic acid is added to all cereal grain products, like breakfast cereals since 1998, which has led to a significant reduction in the number of pregnancies affected and the number of foetal deaths.

EU policy makers should implement forthright policy propositions that will contribute to the effective reduction of NTD through increasing awareness, and folic acid food fortification and supplementation plans.