WHO/CDC Technical Consultation: Optimal blood folate concentrations in women of reproductive age for prevention of neural tube defects
13-15 August 2012, Emory Conference Center, Atlanta, GA, USA
In collaboration with the National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention (CDC)
Scope and Purpose
The World Health Organization (WHO) Vitamin and Mineral Nutrition Information System (VMNIS), hosted at the Department of Nutrition for Health and Development in Geneva, Switzerland was established in 1991 following a request by the World Health Assembly to strengthen surveillance of micronutrient deficiencies at the global level. Efforts have traditionally been focused on anaemia and vitamin A and iodine deficiencies, but, they have recently been extended to other nutrients such as zinc and folate, in response to the global needs. The information on different biomarkers of vitamin and mineral status, the collated survey data along with data from other WHO databases have been used by several projects to estimate the comparative importance of these micronutrients as risk factors associated with premature death, loss of health and disability in different populations.
Birth defects, also known as congenital anomalies, can be defined as structural or functional abnormalities, including metabolic disorders, which are present from birth and can be caused by single gene defects, chromosomal disorders, multifactorial inheritance, environmental teratogens or micronutrient deficiencies. WHO estimates that 260 000 deaths worldwide (about 7% of all neonatal deaths) were caused by birth defects in 2004 and that are among the leading causes of childhood death, chronic illness, and disability in many countries, including developing countries. In an effort to address the emerging importance of birth defect morbidity and mortality, on 21 May 2010 the 63rd World Health Assembly adopted a resolution calling all Member States to promote primary prevention and to enhance the health of children with birth defects by developing and strengthening vital registration and surveillance systems; promoting international cooperation, developing expertise and building capacity; and strengthening research and studies on aetiology, diagnosis and prevention.
The aetiology of birth defects can be complex and multifactorial. Studies have shown that increasing the consumption of folic acid by women during the periconceptional period can significantly reduce the occurrence of neural tube defects (NTDs) which has led to recommendations for women to consume 400 micrograms (0.4 mg) of folic acid daily to reduce their risk of having an NTD-affected pregnancy. Higher amounts of folic acid also can help reduce the recurrence of NTDs. These findings have instigated worldwide efforts to not only promote preconceptional folic acid intake through daily or intermittent supplementation among women who could become pregnant, but also mandatory fortification of staple foods with folic acid.