https://www.who.int/immunization/diseases/tetanus/lancet-2012-global-child-mortality.pdf

Global, regional, and national causes of child mortality: An updated systematic analysis for 2010 with time trends since 2000

Prevention of neural tube defects: Results of the Medical Research Council vitamin study

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(14)61698-6.pdf

Global, regional, and national causes of child mortality in 2000-13, with projections to inform post-2015 priorities: an updated systematic analysis.

This article represents the update of the European Stroke Initiative Recommendations for Stroke Management. These guidelines cover both ischaemic stroke and transient ischaemic attacks, which are now considered to be a single entity. The article covers referral and emergency management, Stroke Unit service, diagnostics, primary and secondary prevention, general stroke treatment, specific treatment including acute management, management of complications, and rehabilitation.

/pdf/guidelines-for-management-of-ischaemic-stroke-and-transient-1bttxqchx4.pdf

Guidelines for management of ischaemic stroke and transient ischaemic attack 2008

Cost Effectiveness in Health and Medicine.

Background Periconceptional use of multivitamins containing folic acid can reduce a woman's risk of having a baby with a neural-tube defect. Methods As part of a public health campaign conducted from 1993 to 1995 in an area of China with high rates of neural-tube defects (the northern region) and one with low rates (the southern region), we evaluated the outcomes of pregnancy in women who were asked to take a pill containing 400 μg of folic acid alone daily from the time of their premarital examination until the end of their first trimester of pregnancy. Results Among the fetuses or infants of 130,142 women who took folic acid at any time before or during pregnancy and 117,689 women who had not taken folic acid, we identified 102 and 173, respectively, with neural-tube defects. Among the fetuses or infants of women who registered before their last menstrual period and who did not take any folic acid, the rates of neural-tube defects were 4.8 per 1000 pregnancies of at least 20 weeks' gestation in the nort...

https://www.nejm.org/doi/pdf/10.1056/NEJM199911113412001

Prevention of Neural-Tube Defects with Folic Acid in China

Folate and DNA Methylation: A Review of Molecular Mechanisms and the Evidence for Folate's Role

BACKGROUND AND METHODS\nPericonceptional administration of folic acid can reduce a woman's risk of having a fetus or infant with a neural-tube defect. As part of a public health campaign conducted from 1993 to 1995 in an area of China with high rates of neural-tube defects (the northern region) and one with low rates (the southern region), we evaluated the outcomes of pregnancy in women who were asked to take a pill containing 400 microg of folic acid alone daily from the time of their premarital examination until the end of their first trimester of pregnancy.\n\n\nRESULTS\nAmong the fetuses or infants of 130,142 women who took folic acid at any time before or during pregnancy and 117,689 women who had not taken folic acid, we identified 102 and 173, respectively, with neural-tube defects. Among the fetuses or infants of women who registered before their last menstrual period and who did not take any folic acid, the rates of neural-tube defects were 4.8 per 1000 pregnancies of at least 20 weeks' gestation in the northern region and 1.0 per 1000 in the southern region. Among the fetuses or infants of the women with periconceptional use of folic acid, the rates were 1.0 per 1000 in the northern region and 0.6 per 1000 in the southern region. The greatest reduction in risk occurred among the fetuses or infants of a subgroup of women in the northern region with periconceptional use who took folic acid pills more than 80 percent of the time (reduction in risk, 85 percent as compared with the fetuses or infants of women who registered before their last menstrual period and who took no folic acid; 95 percent confidence interval, 62 to 94 percent) [corrected]. In the southern region the reduction in risk among the fetuses or infants of women with periconceptional use of folic acid was also significant (reduction in risk, 41 percent; 95 percent confidence interval, 3 to 64 percent).\n\n\nCONCLUSIONS\nPericonceptional intake of 400 microg of folic acid daily can reduce the risk of neural-tube defects in areas with high rates of these defects and in areas with low rates.

Prevention of Neural-Tube Defects With Folic Acid in China

DNA methylation is an epigenetic modification critical to normal genome regulation and development. The vitamin folate is a key source of the one carbon group used to methylate DNA. Because normal mammalian development is dependent on DNA methylation, there is enormous interest in assessing the potential for changes in folate intake to modulate DNA methylation both as a biomarker for folate status and as a mechanistic link to developmental disorders and chronic diseases including cancer. This review highlights the role of DNA methylation in normal genome function, how it can be altered, and the evidence of the role of folate/folic acid in these processes. Adv. Nutr. 3: 21–38, 2012.

Folate and DNA Methylation: A Review of Molecular Mechanisms and the Evidence

Periconceptional intake of folic acid is known to reduce a woman's risk of having an infant affected by a neural tube birth defect (NTD). National programs to mandate fortification of food with folic acid have reduced the prevalence of NTDs worldwide. Uncertainty surrounding possible unintended consequences has led to concerns about higher folic acid intake and food fortification programs. This uncertainty emphasizes the need to continually monitor fortification programs for accurate measures of their effect and the ability to address concerns as they arise. This review highlights the history, effect, concerns, and future directions of folic acid food fortification programs.

/pdf/folic-acid-food-fortification-its-history-effect-concerns-fszk4rxdqt.pdf

Robert J. Berry

Papers

Prevention of Neural-Tube Defects with Folic Acid in China

Folate and DNA Methylation: A Review of Molecular Mechanisms and the Evidence for Folate's Role

Prevention of Neural-Tube Defects With Folic Acid in China

Folate and DNA Methylation: A Review of Molecular Mechanisms and the Evidence

Folic Acid Food Fortification—Its History, Effect, Concerns, and Future Directions