GLOBAL UPDATE ON THE PREVENTION OF FOLIC ACID-PREVENTABLE SPINA BIFIDA AND ANENCEPHALY CASES 公开

Abstract

Abstract

GLOBAL UPDATE ON THE PREVENTION OF
FOLIC ACID-PREVENTABLE SPINA BIFIDA
AND ANENCEPHALY CASES
BY
Monica E. Youngblood
BACKGROUND: Folic acid has been proven to prevent most cases of spina bifida and anencephaly. It is recommended that women of child-bearing age consume folic acid fortified grain products and/or supplements prior to pregnancy. Since 2006, there has been an increase in the number of countries that fortify their flour with folic acid. METHODS: Country specific data on fortification of flour with folic acid has been tracked along with amounts of fortified flour consumed per person. Estimates of spina bifida and anencephaly affected pregnancies and country-specific birth estimates were also utilized to estimate the amount of folic acid preventable spina bifida and anencephaly cases. RESULTS: Utilizing a predetermined prevention factor model, it is estimated that 13.81% of spina bifida and anencephaly cases are currently being prevented with folic acid flour fortification. Since the average US population consumes between 100 and 200 mcg folic acid from fortified flour, and this is associated with a significant decrease in the number of cases of spina bifida and anencephaly, an updated prevention factor model was created. Under these circumstances, it is estimated that 22.38% of spina bifida and anencephaly cases are globally prevented with folic acid flour fortification. CONCLUSIONS: Although these values show an increase in cases prevented since 2006, there is still a significant amount of work required in order to increase consumption of folic acid in women of child-bearing age and for countries to regulate and require flour fortification with folic acid.

GLOBAL UPDATE ON THE PREVENTION OF FOLIC ACID-PREVENTABLE SPINA BIFIDA AND ANENCEPHALY CASES
BY
Monica E. Youngblood
M.P.H., Emory University, 2011
B.S., California State Polytechnic University, Pomona, 2002
Thesis Committee Chair: Godfrey P. Oakley, Jr. MD, MSPM
A Thesis submitted to the Faculty of the
Rollins School of Public Health of Emory University
in partial fulfillment of the requirements of the degree of
Master of Public Health in the Career MPH program
2011

Table of Contents

Table of Contents:

Distribution Agreement .................................................................................................................. 1
Approval Page ................................................................................................................................. 2
Abstract Cover Page ........................................................................................................................ 3
Abstract ........................................................................................................................................... 4
Cover Page ...................................................................................................................................... 5
Introduction .................................................................................................................................... 7
Literature Review…………………………………………………………………………………..…………………………..……11
Data Collection………………………………………………………………………………………………………………………..14
Analysis……………………………………………………………………………………………………………………………………16
Results……………………………………………………………………………………………………………………………………..17
Table 1……………………………………………………………………………………………………………………………………..18
Table 2……………………………………………………………………………………………………………………………………..22
Table 1/Table 2 Key………………………………………………………………………………………………………………….26
Figure 1…………..……………………………………………………………………………………………………………………....27
Figure 2………..………………………………………………………………………………………………………………………....27
Discussion……………………………………………………………………………………………………………………………..…28
References……………………………………………………………………………………………………………………………….30
Journal Article Title Page…………………………………………………………………………………………………..……..32
Abstract……………………………………………………………………………………………………………………………………33
Key Words……………………………………………………………………………………………………………………………….33
Introduction…………………………………………………………………………………………………………………………….33
Methods………………………………………………………………………………………………………………………………….35
Results……………………………………………………………………………………………………………………………………..36
Discussion……..………………………………………………………………………………………………………………………..36
Literature Cited….…………………………………………………………………………………………………………………….38
Table 1……………………………………………………………………………………………………………………………………..40
Table 2……………………………………………………………………………………………………………………………………..44
Table 1/Table 2 Key………………………………………………………………………………………………………………….48
Figure 1…………..……………………………………………………………………………………………………………………....49
Figure 2………..………………………………………………………………………………………………………………………....49





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About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Career Masters of Public Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
关键词	anencephaly spina bifida flour fortification folic acid prevention
Committee Chair / Thesis Advisor	Oakley Jr., Godfrey, Emory University
Committee Members	Butler, Susan O, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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