Nutrition

Sponsored symposium: Blood folate cut-offs in women of reproductive age. Evidence to inform WHO guidelines for neural tube defects prevention

In collaboration with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), USA

Addis Ababa, Ethiopia, 2 June 2014
Micronutrient Forum Global Conference
Location: United Nations Conference Center (12:30 – 14:00, Room LBR)

Scope and purpose

Congenital anomalies, also known as birth defects, 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 270 000 deaths worldwide (about 7% of all neonatal deaths) were caused by birth defects in 2010 and that are among the leading causes of childhood death, chronic illness, and disability in many 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.

Current folate cut-offs are focused on the prevention of megaloblastic anaemia in all age groups. However, it is possible that blood folate concentrations in women of reproductive age need to be higher to help prevent neural tube defect-affected pregnancies. The establishment of optimal blood folate concentrations entails many challenges.

There is scarce information on the direct relationship between folic acid intake and blood folate concentrations to neural tube defects occurrence, from both intervention trials and observational studies. These associations may also be affected by technical, genetic, biological, safety and contextual factors that need to be considered when examining and interpreting the existing data.

The Department of Nutrition for Health and Development, World Health Organization, and the Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC) are convening this symposium within the Micronutrient Forum Global Conference.

The overall objective of this session is to update the nutrition community on current knowledge about blood folate concentrations and preventable neural tube defects. The specific objectives are to:

  • Provide an update of the global folate status of women of reproductive age and the prevalence of neural tube defects;
  • Present a review of the estimate of the optimal folate concentration in women of reproductive age for the prevention of neural tube defects;
  • Discuss interventions for improving folate status of women of reproductive age;
  • Present successes and challenges in the implementation of folate interventions for women of reproductive age; and
  • Present a log frame for the monitoring and evaluation of folate interventions.

Session chairs

  • Dr Francesco Branca, Director, Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland
  • Dr Patrick Stover, Cornell University, Ithaca, United States of America

Presenters

12:30   Evidence retrieval, summary and assessment for establishing blood folate cut-offs in women of reproductive age. Dr Luz Maria De-Regil, Micronutrient Initiative, Ottawa, Canada

12:50   Using data modeling as indirect evidence for guideline development. Dr Krista Crider, Centers for Disease Control and Prevention, Atlanta, United States of America

13:10   Development of WHO guideline on blood folate cut-offs in women of reproductive age and challenges for implementation. Dr Lisa Rogers, World Health Organization, Geneva, Switzerland

13:30   Building capacity for blood folate measurements – a harmonized laboratory network. Dr Mindy Zhang, Centers for Disease Control and Prevention, Atlanta, United States of America

13:50   Discussion

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