Pérez-Escamilla R
Department of Nutritional Services, University of Connecticut, Storrs, United States of America.
Bull Pan Am Health Organ. 1995 Sep;29(3):250-63.
This review examines evidence linking periconceptional folic acid intake to neural tube defects (NTDs) and related public health issues in the United States and developing countries. Sources of information were identified through on-line searches (Medline, UCAT-University of Connecticut) and by contacting researchers in the field. The distribution of NTDs varies across regions. Recurrent NTDs can be prevented with high-dosage folic acid supplementation during periconception, but it is not clear if such a protective effect can be achieved with lower dosages or in low-NTD-risk populations. Overall, it appears that women with a previous NTD pregnancy should receive folic acid supplementation during periconception under medical guidance. Dietary counseling regarding foods rich in folate should be given to all women of childbearing age. However, primary prevention of NTDs through widespread food fortification with folic acid seems unwarranted in both the United States and developing countries due to the low prevalence of NTDs relative to other problems and a potentially unfavorable benefit/risk ratio.
本综述探讨了美国及发展中国家孕期前后叶酸摄入量与神经管缺陷（NTDs）及相关公共卫生问题之间的联系。通过在线搜索（医学文献数据库、康涅狄格大学的UCAT）以及联系该领域的研究人员来确定信息来源。神经管缺陷的分布因地区而异。复发性神经管缺陷可通过孕期前后补充高剂量叶酸来预防，但尚不清楚较低剂量或低神经管缺陷风险人群是否也能获得这种保护作用。总体而言，曾有过神经管缺陷妊娠史的女性似乎应在医学指导下于孕期前后补充叶酸。应向所有育龄妇女提供关于富含叶酸食物的饮食咨询。然而，鉴于相对于其他问题而言神经管缺陷的患病率较低，以及潜在的不利效益/风险比，在美国和发展中国家，通过广泛的食物叶酸强化来进行神经管缺陷的一级预防似乎并无必要。
