Martínez de Villarreal Laura, Pérez Jesús Z Villarreal, Vázquez Patricia Arredondo, Herrera Ricardo Hernández, Campos Ma Del Roble Velazco, López Roberto Ambriz, Ramírez José Luis Herrera, Sánchez Jesús Manuel Yañez, Villarreal Juan José Morales, Garza Manuel Treviño, Limón Adriana, López Abel Guzmán, Bárcenas Mario, García Juan Ramón Cepeda, Domínguez Andrés Sánchez, Nuñez Rogelio Hernández, Ayala Jorge Luis García, Martínez Jorge Garza, González Mario Tijerina, Alvarez Carlos García, Castro Roberto Negrete
Unidad de Genética y Defectos Congénitos, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, N.L. Mexico.
Teratology. 2002 Nov;66(5):249-56. doi: 10.1002/tera.10094.
Nuevo León is a state in northeastern Mexico, near the border of Texas. Mean mortality rate from 1996-98 due to anencephaly cases was 0.6/1,000. In 1999 a surveillance program for the registry and prevention of neural tube defects (NTD) cases was initiated.
Cases were obtained from hospitals and OB-GYN clinics by immediate notification, death certificates, or fetal death registries. Only isolated cases of NTD were included. In August 1999 a folic acid campaign was initiated with the free distribution of the vitamin to low-income women with a recommendation to take a 5.0-mg pill once a week. Number of cases and rates from 1999 to 2001 were compared (chi(2) test).
After 2 years there has been a significant reduction in the number of cases and rates. In 1999 there were 95 NTD cases and in the years 2000 and 2001 there were only 59 and 55 respectively (P < 0.001). NTD rate decreased from 1.04/1,000 in 1999 to 0.58/1,000 in 2001. Anencephaly and spina bifida rates decreased from 0.55/1,000 to 0.29/1,000 and from 0.47/1,000 to 0.22/1,000 respectively, from 1999-2001. Decrease of female cases was higher than male cases for both phenotypes.
After 2 years there was a 50% decrease in the incidence of anencephaly and spina bifida cases with a significant reduction of infant mortality and disability. These results encourage us to propose the use of a single tablet of 5.0-mg of folic acid per week as an alternative to supplementation on a daily basis.
新莱昂州是墨西哥东北部的一个州，靠近得克萨斯州边境。1996 - 1998年因无脑儿病例导致的平均死亡率为0.6/1000。1999年启动了一项神经管缺陷（NTD）病例登记和预防监测计划。
通过即时通报、死亡证明或死胎登记从医院和妇产科诊所获取病例。仅纳入孤立的NTD病例。1999年8月发起了一项叶酸运动，向低收入妇女免费发放维生素，建议每周服用一片5.0毫克的药片。比较了1999年至2001年的病例数和发病率（卡方检验）。
2年后病例数和发病率显著下降。1999年有95例NTD病例，2000年和2001年分别仅有59例和55例（P < 0.001）。NTD发病率从1999年的1.04/1000降至2001年的0.58/1000。无脑儿和脊柱裂发病率分别从1999 - 2001年的0.55/1000降至0.29/1000和从0.47/1000降至0.22/1000。两种表型的女性病例减少幅度均高于男性病例。
2年后无脑儿和脊柱裂病例的发病率下降了50%，婴儿死亡率和残疾率显著降低。这些结果促使我们提议每周使用一片5.0毫克的叶酸片作为每日补充的替代方案。
