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首页> 外文期刊>American journal of medical genetics, Part A >Wheat flour fortification with folic acid: Changes in neural tube defects rates in Chile
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Wheat flour fortification with folic acid: Changes in neural tube defects rates in Chile

机译：叶酸强化小麦粉：智利神经管缺陷率的变化

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摘要

In January 2000, Chilean Ministry of Health mandated the addition of folic acid (FA) to wheat flour in order to reduce the risk of neural tube defects (NTDs). This policy resulted in significant increases in serum and red cell folate in women of fertile age 1 year after fortification. To evaluate the effect of wheat flour fortification on the prevalence of NTDs in Chile we designed a prospective hospital-based surveillance program to monitor the frequency of NTDs in all births (live and stillbirths) with birth weight ≥500g at the nine public maternity hospitals of Santiago, Chile from 1999 to 2009. During the pre-fortification period (1999-2000) the NTD rate was 17.1/10,000 births in a total of 120,566 newborns. During the post-fortification period (2001-2009) the NTD rate decreased to 8.6/10,000 births in a total of 489,915 newborns, which translates into a rate reduction of 50% (RR: 0.5; 95% CI: 0.42-0.59) for all NTDs. The rate reduction by type of NTD studied was: 50% in anencephaly (RR: 0.5; 95% CI: 0.38-0.67), 42% in cephalocele (RR: 0.58; 95% CI: 0.37-0.89), and 52% in spina bifida (RR: 0.48; 95% CI: 0.38-0.6). Rates showed significant reduction both in stillbirths and live births: 510.3 to 183.6/10,000 (RR=0.36; 95% CI: 0.25-0.53) and 13.3 to 7.5/10,000 (RR=0.56; 95% CI: 0.47-0.68), respectively. In Chile, fortification of wheat flour with FA has proven to be an effective strategy for the primary prevention of NTDs.
机译：2000年1月，智利卫生部要求在小麦粉中添加叶酸（FA），以降低神经管畸形（NTD）的风险。这项政策导致设防后1年的育龄妇女血清和红细胞叶酸显着增加。为了评估小麦粉强化对智利NTD患病率的影响，我们设计了一项基于医院的前瞻性监测计划，以监测智利9家公立妇产医院所有出生体重≥500 g的婴儿（活产和死产）中NTD的发生率。从1999年到2009年，智利圣地亚哥。在强化前阶段（1999-2000年），在120,566名新生儿中，NTD率为17.1 / 10,000出生。在强化后时期（2001-2009年），NTD患病率下降到8.6 / 10,000，共489,915名新生儿，这意味着其NTD患病率降低了50％（RR：0.5; 95％CI：0.42-0.59）。所有NTD。按所研究的NTD类型降低的比率为：无脑50％（RR：0.5; 95％CI：0.38-0.67），头膨出42％（RR：0.58; 95％CI：0.37-0.89）和52％脊柱裂（RR：0.48; 95％CI：0.38-0.6）。死胎率和活产率均显着降低：分别为510.3至183.6 / 10,000（RR = 0.36; 95％CI：0.25-0.53）和13.3至7.5 / 10,000（RR = 0.56; 95％CI：0.47-0.68） 。在智利，事实证明，用FA强化小麦面粉是一级预防NTD的有效策略。

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