Improving maternal folate status to prevent infant neural tube defects: working group conclusions and a framework for action

• Published in: Annals of the New York Academy of Sciences 2018-02, Vol.1414 (1), p.5-19
• Main Authors: Martinez, Homero, Weakland, Aliki P., Bailey, Lynn B., Botto, Lorenzo D., De‐Regil, Luz Maria, Brown, Kenneth H.
• Format: Article
• Language: English
• Subjects: Adolescent; Birth; Birth defects; Child mortality; Congenital defects; Consultation; Control programs; Developing Countries; Disease control; Epidemiological Monitoring; Erythrocytes - metabolism; Feasibility; Feasibility studies; Female; Folic acid; Folic Acid - administration & dosage; Folic Acid - blood; Folic Acid - economics; Food, Fortified - economics; Humans; Infant; Infant, Newborn; Infectious diseases; Male; Mortality; Neural tube defects; Neural Tube Defects - blood; Neural Tube Defects - epidemiology; Neural Tube Defects - prevention & control; Pregnancy; Prevention; Risk Factors; Toll roads; Vitamin B; Vitamin B 12 - administration & dosage
• ISSN: 0077-8923; 1749-6632
• DOI: 10.1111/nyas.13593

As infectious disease control programs achieve increasing success, further reductions in child mortality in low‐ and middle‐income countries (LMICs) will require focused prevention strategies for birth defects and other noninfectious diseases. Neural tube defects (NTDs) can cause early death or lifelong disability. Preventing NTDs provides a feasible, significant opportunity to decrease the toll of birth defects and contribute to further reducing child mortality globally. The Micronutrient Forum convened a technical consultation on Folate Status in Women and Neural Tube Defects Prevention to develop a roadmap to inform and prioritize investments in NTD prevention in LMICs; help guide implementation efforts in terms of the feasibility of interventions and the potential for acceleration; and identify research and knowledge gaps. Here, we describe the impetus for and approach to the consultation and present the conclusions and a framework for developing a roadmap for action to accelerate NTD prevention in LMICs. The framework (1) provides options for action on folate status assessment; (2) outlines a way forward to develop and implement a time‐bound global action plan for NTD prevention; and (3) identifies common impediments to NTD prevention, broad strategies to overcome or minimize these impediments, and basic building blocks necessary to accelerate action.