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Journal of Pregnancy
Volume 2012, Article ID 295083, 9 pages
http://dx.doi.org/10.1155/2012/295083
Review Article

Periconceptional Folate Deficiency and Implications in Neural Tube Defects

1Department of Obstetrics and Gynecology, St Joseph University, Hôtel-Dieu de France, 1100 Beirut, Lebanon
2Department of Pediatric Surgery, Children’s Hospital of Dijon, University Medical Center, 21000 Dijon, France
3Department of Obstetrics and Fetal Medicine, Hôpital Necker-Enfants-Malades, Paris Descartes University, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France

Received 5 March 2012; Revised 3 May 2012; Accepted 4 June 2012

Academic Editor: Laura Murray-Kolb

Copyright © 2012 J. Safi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Nutritional deficiencies are preventable etiological and epigenetic factors causing congenital abnormalities, first cause of infant mortality. Folate deficiency has a well-established teratogenic effect, leading to an increasing risk of neural tube defects. This paper highlights the most recent medical literature about folate deficiency, be it maternal or paternal. It then focuses on associated deficiencies as nutritional deficiencies are multiple and interrelated. Observational and interventional studies have all been consistent with a 50–70% protective effect of adequate women consumption of folates on neural tube defects. Since strategies to modify women’s dietary habits and vitamin use have achieved little progress, scientific as well as political effort is mandatory in order to implement global preventive public health strategies aimed at improving the alimentation of women in reproductive age, especially folic acid supplementation. Even with the recent breakthrough of fetal surgery for myelomeningocele, the emphasis should still be on prevention as the best practice rather than treatment of neural tube defects.