Meijer W M, de Walle H E K
Universitair Medisch Centrum Groningen, European Registration Of Congenital Anomalies and Twins (EUROCAT), disciplinegroep Medische Genetica, Triadegebouw, Groningen.
Ned Tijdschr Geneeskd. 2005 Nov 12;149(46):2561-4.
The European Registration Of Congenital Anomalies and Twins (EUROCAT), a network of 40 European registries of congenital anomalies, has published a special report on the prevention of neural-tube defects by, periconceptional folic-acid supplementation in Europe. This report reviews the progress made in 17 European countries since i99I in terms of developing and implementing public health policies to raise periconceptional folate status. Data on the prevalence of neural-tube defects in 1980-2000 were also analysed. - At the beginning of 2002, 10 of the 17 countries had an official government recommendation that women planning a pregnancy should take folic-acid supplementation daily. Only 7 countries implemented official health-education initiatives. - Despite the various measures taken to date, the majority of women in all countries surveyed are not taking periconceptional folic-acid supplements. Even in the Netherlands, where the percentage of planned pregnancies is estimated at 85%, only 36% of women take folic-acid supplements during the advised period. - Overall, the number of neural-tube defects has not decreased in Europe. A slight decrease was seen in those countries with an official policy regarding periconceptional folic-acid supplementation. - It is clear from the report that more effective prevention of neuraltube defects could be achieved with folic-acid fortification of staple foods; this approach has led to a reduction in the prevalence of neuraltube defects in the US and Canada. This approach can also prevent the majority of neural-tube defects in unplanned pregnancies and reduce the socioeconomic differences in prevalence.
欧洲先天性异常和双胞胎登记系统（EUROCAT）是一个由40个欧洲先天性异常登记处组成的网络，它发表了一份关于欧洲围孕期补充叶酸预防神经管缺陷的特别报告。本报告回顾了自1991年以来17个欧洲国家在制定和实施提高围孕期叶酸水平的公共卫生政策方面取得的进展。还分析了1980 - 2000年神经管缺陷患病率的数据。 - 2002年初，17个国家中有10个国家有政府官方建议，计划怀孕的妇女应每日补充叶酸。只有7个国家实施了官方健康教育倡议。 - 尽管迄今采取了各种措施，但在所有接受调查的国家中，大多数妇女并未服用围孕期叶酸补充剂。即使在荷兰，预计计划怀孕的比例为85%，但在建议期间只有36%的妇女服用叶酸补充剂。 - 总体而言，欧洲神经管缺陷的数量并未减少。在那些有围孕期补充叶酸官方政策的国家中，略有下降。 - 从报告中可以清楚地看出，通过主食强化叶酸可以更有效地预防神经管缺陷；这种方法已导致美国和加拿大神经管缺陷患病率降低。这种方法还可以预防大多数意外怀孕中的神经管缺陷，并减少患病率方面的社会经济差异。
