Simpson J L, Mills J L, Rhoads G G, Cunningham G C, Hoffman H J, Conley M R
University of Tennessee, Memphis.
Prenat Diagn. 1991 Aug;11(8):641-8. doi: 10.1002/pd.1970110823.
No clear answer concerning whether multivitamin/folate supplementation prevents neural tube defects (NTDs) is provided by three studies in the United States. All these studies are occurrence in nature, no recurrence studies having been conducted. The Atlanta Birth Defects Study is subject to pronounced memory and recall biases, the length between event and interview being as long as 16 years. In a second study (Boston University), objections can be raised to certain aspects of the experimental design, and the claim that 22 per cent of women started vitamins sufficiently early after pregnancy diagnosis to influence NTD formation is suspicious. Our NICHD case control study of 541 women in California and Illinois revealed no evidence for multivitamins or folic acid preventing NTDs. U.S. public policy-makers face difficulties in applying results of recurrence or occurrence studies in high-risk areas to low-risk areas in the U.S.
美国的三项研究并未就多种维生素/叶酸补充剂能否预防神经管缺陷（NTDs）给出明确答案。所有这些研究均为关于发病率的研究，尚未开展关于复发率的研究。亚特兰大出生缺陷研究存在明显的记忆和回忆偏差，事件发生与访谈之间的间隔长达16年。在第二项研究（波士顿大学）中，实验设计的某些方面可能会遭到质疑，而且声称22%的女性在确诊怀孕后足够早地开始服用维生素从而影响神经管缺陷的形成这一说法也值得怀疑。我们美国国立儿童健康与人类发展研究所对加利福尼亚州和伊利诺伊州541名女性进行的病例对照研究并未发现多种维生素或叶酸能够预防神经管缺陷的证据。美国公共政策制定者在将高危地区复发率或发病率研究的结果应用于美国的低危地区时面临困难。
