Kalter H
Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA.
Reprod Toxicol. 2000 Sep-Oct;14(5):463-76. doi: 10.1016/s0890-6238(00)00093-9.
A large body of evidence gathered over the past 30 or more years has led to the firmly established belief that deficiency of the vitamin folic acid is a cause of congenital malformations of neural tube closure. Beginning with studies showing folic acid levels of mothers of children with such defects to be low, this belief has been solidified by epidemiologic studies revealing that this consequence is prevented by maternal supplements of the vitamin from early pregnancy. The present article reviews this evidence for the purpose of examining the claims of the efficacy of folic acid in this respect. This seems to be an advantageous moment to do so, because no clear impact of folic acid supplementation and fortification on the prevalence of neural tube defects has as yet been documented; and furthermore a pause seems to have been reached in such studies. It is felt that a historical, i.e. a chronologic approach will best describe the findings, and therefore they will be considered as they unfolded.
在过去30多年里收集的大量证据使人们坚信，维生素叶酸缺乏是神经管闭合先天性畸形的一个原因。从显示患有此类缺陷儿童的母亲叶酸水平较低的研究开始，这一信念因流行病学研究而得到强化，这些研究表明，从怀孕早期开始，母亲补充这种维生素可预防这种后果。本文回顾这一证据，目的是审视叶酸在这方面的功效说法。现在这样做似乎是个有利时机，因为尚未有文献记载补充叶酸和强化叶酸对神经管缺陷患病率有明显影响；此外，此类研究似乎已进入一个停顿阶段。人们认为，采用历史的、即按时间顺序的方法将最能描述这些研究结果，因此将按照其发展过程来进行考量。
