Authors:
Bower C, Halliday J
Keywords:
Neural tube defects, folate, folic acid, fortification, Australia
Abstract:
Historically, neural tube defects in Australia have affected around 2 per 1,000 births.
Promotion of periconceptional folic acid supplement use began in Australia following publication of randomised trials showing effectiveness.
30-50% of Australian women take perconceptional folic acid supplements.
Voluntary fortification of selected foods (mainly breads, breakfast cereals) with folic acid was permitted in 19995 in Australia, but uptake was limited.
There was a 20-30% fall in NTD in association with supplement use and voluntary fortification.
Mandatory fortification of wheat flour for bread making was legislated in 2007 in Australia and required by September 2009.
A framework for monitoring mandatory fortification has been established.
There is evidence of an increase in serum and red cell floated status following mandatory fortification, but it is too soon to observe an effect on NTD.
In order to monitor trends in NTD, it is critical to have complete ascertainment from livebirths, stillbirths and terminations of pregnancy.