Podcast
Questions and Answers
Folic acid does not prevent the neurologic ______ consequences of vitamin B12 deficiency.
Folic acid does not prevent the neurologic ______ consequences of vitamin B12 deficiency.
consequences
The USPHS recommendation cautioned that intake of folate should be not more than ______ mg per day.
The USPHS recommendation cautioned that intake of folate should be not more than ______ mg per day.
1000
Routine prenatal screening for ______ is still advisable.
Routine prenatal screening for ______ is still advisable.
NTDs
The tolerable upper intake limit of synthetic folic acid was set at ______ mg.
The tolerable upper intake limit of synthetic folic acid was set at ______ mg.
Women with a history of a previous pregnancy resulting in a fetus with an ______ should be advised to consume high levels of folic acid.
Women with a history of a previous pregnancy resulting in a fetus with an ______ should be advised to consume high levels of folic acid.
Studies that definitively address the question of maternal and fetal safety of folic acid are ______.
Studies that definitively address the question of maternal and fetal safety of folic acid are ______.
About a quarter of all women have consumed folic acid during ______ pregnancy without apparent adverse effects.
About a quarter of all women have consumed folic acid during ______ pregnancy without apparent adverse effects.
High-risk women should consume ______ mg of folic acid per day when a pregnancy is not planned.
High-risk women should consume ______ mg of folic acid per day when a pregnancy is not planned.
A daily dosage of ______ mg of folic acid resulted in a 71% reduction of recurrence of NTDs.
A daily dosage of ______ mg of folic acid resulted in a 71% reduction of recurrence of NTDs.
The recommendations were developed by the US Public Health Service and the Centers for Disease ______.
The recommendations were developed by the US Public Health Service and the Centers for Disease ______.
There are two separate recommendations for women based on their history of a previous ______-affected pregnancy.
There are two separate recommendations for women based on their history of a previous ______-affected pregnancy.
The addition of other vitamins to the dosage of folic acid did not reduce the ______ further.
The addition of other vitamins to the dosage of folic acid did not reduce the ______ further.
Use of multivitamins without ______ did not result in a reduced risk for NTDs.
Use of multivitamins without ______ did not result in a reduced risk for NTDs.
An earlier study suggested that a lower dosage of ______ mg of folic acid could still provide benefits.
An earlier study suggested that a lower dosage of ______ mg of folic acid could still provide benefits.
The recommendations do not indicate an exclusive course of ______ or serve as a standard of medical care.
The recommendations do not indicate an exclusive course of ______ or serve as a standard of medical care.
The study referenced was conducted in the United ______.
The study referenced was conducted in the United ______.
Fewer than 1 in 3 women consume the amount of ______ recommended by the USPHS.
Fewer than 1 in 3 women consume the amount of ______ recommended by the USPHS.
The prevention of NTDs depends on an urgent and effective campaign to close this ______.
The prevention of NTDs depends on an urgent and effective campaign to close this ______.
Regular ingestion of folic acid by women of childbearing age is necessary because approximately half of the pregnancies in the United States are ______.
Regular ingestion of folic acid by women of childbearing age is necessary because approximately half of the pregnancies in the United States are ______.
Neural tube closure occurs during the first ______ weeks of gestation.
Neural tube closure occurs during the first ______ weeks of gestation.
The publication of the USPHS recommendation occurred in ______ 1992.
The publication of the USPHS recommendation occurred in ______ 1992.
Despite recommendations, a 1998 poll showed that 70% of women aged 18 to 45 years still are not following the USPHS ______.
Despite recommendations, a 1998 poll showed that 70% of women aged 18 to 45 years still are not following the USPHS ______.
Neural tube defects (NTDs) are among the most common ______ defects contributing to infant mortality.
Neural tube defects (NTDs) are among the most common ______ defects contributing to infant mortality.
The Academy notes that all women of childbearing age who are capable of becoming pregnant take ______ mg of folic acid daily.
The Academy notes that all women of childbearing age who are capable of becoming pregnant take ______ mg of folic acid daily.
Women with a close relative (eg, sibling, niece, or nephew) who has an ______ has an increased risk.
Women with a close relative (eg, sibling, niece, or nephew) who has an ______ has an increased risk.
Women with type 1 diabetes mellitus have a risk of approximately ______ percent for NTDs.
Women with type 1 diabetes mellitus have a risk of approximately ______ percent for NTDs.
Women treated with valproic acid or carbamazepine have a risk of approximately ______ percent for NTDs.
Women treated with valproic acid or carbamazepine have a risk of approximately ______ percent for NTDs.
For a woman who has an NTD, the risk for an affected child may be between ______ to ______ percent.
For a woman who has an NTD, the risk for an affected child may be between ______ to ______ percent.
Women planning a pregnancy should discuss folic acid intake of ______ mg with their physician.
Women planning a pregnancy should discuss folic acid intake of ______ mg with their physician.
The recommended intake of periconceptional folic acid for women at risk is ______ mg.
The recommended intake of periconceptional folic acid for women at risk is ______ mg.
The AAP recommends that women discuss NTD risks with their ______.
The AAP recommends that women discuss NTD risks with their ______.
The references indicate that the use of folic acid has been recommended since ______.
The references indicate that the use of folic acid has been recommended since ______.
The ______ is responsible for public health and safety recommendations in the United States.
The ______ is responsible for public health and safety recommendations in the United States.
Michele Lloyd-Puryear, MD, PhD, contributed to research published in the ______.
Michele Lloyd-Puryear, MD, PhD, contributed to research published in the ______.
Neural tube defects and congenital malformations are discussed in ______ practices.
Neural tube defects and congenital malformations are discussed in ______ practices.
Felix de la Cruz, MD, MPH highlighted the need for caution regarding ______ and birth defects.
Felix de la Cruz, MD, MPH highlighted the need for caution regarding ______ and birth defects.
The ______ Academy of Pediatrics advocates for children's health and welfare.
The ______ Academy of Pediatrics advocates for children's health and welfare.
The educational program aims to prevent folic acid–preventable ______ throughout the use of supplements.
The educational program aims to prevent folic acid–preventable ______ throughout the use of supplements.
The effective folate dose is being studied to further refine its ______ and mechanisms of action.
The effective folate dose is being studied to further refine its ______ and mechanisms of action.
The AAP encourages additional efforts at devising a program of food ______ with folic acid.
The AAP encourages additional efforts at devising a program of food ______ with folic acid.
The recommendation advises that all women capable of becoming pregnant should receive a daily intake of 400 mg of ______.
The recommendation advises that all women capable of becoming pregnant should receive a daily intake of 400 mg of ______.
Surveillance of effectiveness and adverse outcomes in the educational program is critical for ______ its strategies.
Surveillance of effectiveness and adverse outcomes in the educational program is critical for ______ its strategies.
The Centers for Disease Control and Prevention provided recommendations for the use of folic acid to reduce cases of spina ______ and other neural tube defects.
The Centers for Disease Control and Prevention provided recommendations for the use of folic acid to reduce cases of spina ______ and other neural tube defects.
The knowledge and use of folic acid by women of ______ age was studied in the United States during 1995 and 1998.
The knowledge and use of folic acid by women of ______ age was studied in the United States during 1995 and 1998.
Vitamin supplementation is suggested for the prevention of neural tube defect ______.
Vitamin supplementation is suggested for the prevention of neural tube defect ______.
What is the primary recommendation for women capable of becoming pregnant to prevent neural tube defects?
What is the primary recommendation for women capable of becoming pregnant to prevent neural tube defects?
What is the increased daily intake of folic acid recommended for women with a history of NTD-affected pregnancies?
What is the increased daily intake of folic acid recommended for women with a history of NTD-affected pregnancies?
What period is critical for effective folic acid supplementation to prevent neural tube defects?
What period is critical for effective folic acid supplementation to prevent neural tube defects?
What percentage of children with neural tube defects are born to parents with no family history of these defects?
What percentage of children with neural tube defects are born to parents with no family history of these defects?
How much NTDs can be prevented by proper folic acid intake according to studies?
How much NTDs can be prevented by proper folic acid intake according to studies?
What two organizations collaborated to develop recommendations regarding folic acid intake for NTD prevention?
What two organizations collaborated to develop recommendations regarding folic acid intake for NTD prevention?
Why is regular intake of folic acid particularly important for women of childbearing age?
Why is regular intake of folic acid particularly important for women of childbearing age?
What is the effective outcome of the AAP's recommendations regarding folic acid use?
What is the effective outcome of the AAP's recommendations regarding folic acid use?
What is the recommended daily intake of folic acid for women with a history of a previous NTD-affected pregnancy?
What is the recommended daily intake of folic acid for women with a history of a previous NTD-affected pregnancy?
How does the addition of other vitamins to the recommended folic acid dosage affect the risk of NTDs?
How does the addition of other vitamins to the recommended folic acid dosage affect the risk of NTDs?
What percentage reduction in recurrence of NTDs is associated with a daily dosage of 4000 mg of folic acid?
What percentage reduction in recurrence of NTDs is associated with a daily dosage of 4000 mg of folic acid?
What was the suggested lower dosage of folic acid that might still yield benefits, according to earlier studies?
What was the suggested lower dosage of folic acid that might still yield benefits, according to earlier studies?
What is the recommended daily intake of folic acid for women capable of becoming pregnant?
What is the recommended daily intake of folic acid for women capable of becoming pregnant?
What are the primary organizations responsible for developing the recommendations regarding folic acid intake?
What are the primary organizations responsible for developing the recommendations regarding folic acid intake?
What condition does the educational program specifically aim to prevent through folic acid supplementation?
What condition does the educational program specifically aim to prevent through folic acid supplementation?
What approach does the statement take regarding the recommendations for folic acid dosage?
What approach does the statement take regarding the recommendations for folic acid dosage?
Why is regular ingestion of folic acid particularly important for women of childbearing age?
Why is regular ingestion of folic acid particularly important for women of childbearing age?
What has the Academy of Pediatrics encouraged regarding food fortification?
What has the Academy of Pediatrics encouraged regarding food fortification?
What is the relationship between multivitamins without folic acid and the risk for NTDs?
What is the relationship between multivitamins without folic acid and the risk for NTDs?
What critical period in gestation is folic acid most important for preventing NTDs?
What critical period in gestation is folic acid most important for preventing NTDs?
What specific population should the educational program and recommendations be targeting?
What specific population should the educational program and recommendations be targeting?
What are the expected outcomes of implementing surveillance in the educational program?
What are the expected outcomes of implementing surveillance in the educational program?
Which organization is responsible for the public health recommendations regarding folic acid?
Which organization is responsible for the public health recommendations regarding folic acid?
What adverse outcomes might arise from insufficient folic acid intake during pregnancy?
What adverse outcomes might arise from insufficient folic acid intake during pregnancy?
What is the recommended daily intake of folic acid for women of childbearing age?
What is the recommended daily intake of folic acid for women of childbearing age?
Why is regular ingestion of folic acid particularly necessary for women of childbearing age?
Why is regular ingestion of folic acid particularly necessary for women of childbearing age?
What percentage of women aged 18 to 45 years were not following the USPHS recommendation according to a 1998 poll?
What percentage of women aged 18 to 45 years were not following the USPHS recommendation according to a 1998 poll?
What serious birth defects are primarily associated with a deficiency in folic acid?
What serious birth defects are primarily associated with a deficiency in folic acid?
What organization recommends that all women capable of becoming pregnant take folic acid?
What organization recommends that all women capable of becoming pregnant take folic acid?
What does the prevention of neural tube defects depend on according to health experts?
What does the prevention of neural tube defects depend on according to health experts?
How can the incidence of neural tube defects be reduced?
How can the incidence of neural tube defects be reduced?
What is a significant outcome of not consuming the recommended amount of folic acid?
What is a significant outcome of not consuming the recommended amount of folic acid?
What role does folic acid play in preventing neural tube defects?
What role does folic acid play in preventing neural tube defects?
Identify one group of women who should consider higher doses of folic acid.
Identify one group of women who should consider higher doses of folic acid.
What is one consequence of insufficient folic acid intake before and during early pregnancy?
What is one consequence of insufficient folic acid intake before and during early pregnancy?
How do public health recommendations on folic acid serve women planning to conceive?
How do public health recommendations on folic acid serve women planning to conceive?
What has research shown about folic acid supplementation in preventing spinal cord defects?
What has research shown about folic acid supplementation in preventing spinal cord defects?
Which organizations are responsible for providing guidelines on folic acid intake?
Which organizations are responsible for providing guidelines on folic acid intake?
Explain why women capable of becoming pregnant are advised to take folic acid even if they are not planning a pregnancy.
Explain why women capable of becoming pregnant are advised to take folic acid even if they are not planning a pregnancy.
Why is folic acid supplementation considered more effective than dietary folate in preventing NTDs?
Why is folic acid supplementation considered more effective than dietary folate in preventing NTDs?
What daily dosage of folic acid is recommended for women of childbearing age without a history of NTD-affected pregnancy?
What daily dosage of folic acid is recommended for women of childbearing age without a history of NTD-affected pregnancy?
What potential barriers may prevent women from achieving the recommended dietary folate intake?
What potential barriers may prevent women from achieving the recommended dietary folate intake?
What role does food fortification play in achieving the recommended intake of folic acid?
What role does food fortification play in achieving the recommended intake of folic acid?
What is the significance of the AAP's endorsement of the USPHS recommendation regarding folic acid intake?
What is the significance of the AAP's endorsement of the USPHS recommendation regarding folic acid intake?
In the absence of optimal food fortification, what alternative does the AAP recommend for women?
In the absence of optimal food fortification, what alternative does the AAP recommend for women?
How does higher folic acid intake relate to vitamin B12 deficiency?
How does higher folic acid intake relate to vitamin B12 deficiency?
What is the primary reason for advising all women of childbearing age to consume folic acid?
What is the primary reason for advising all women of childbearing age to consume folic acid?
What are some examples of occult spinal dysraphisms (OSDs)?
What are some examples of occult spinal dysraphisms (OSDs)?
How does spina bifida occulta (SBO) differ from other forms of spina bifida?
How does spina bifida occulta (SBO) differ from other forms of spina bifida?
What role do cutaneous abnormalities play in diagnosing occult spinal dysraphisms?
What role do cutaneous abnormalities play in diagnosing occult spinal dysraphisms?
Why might occult spinal dysraphisms go undiagnosed for a long time?
Why might occult spinal dysraphisms go undiagnosed for a long time?
What types of neurological impairments are associated with occult spinal dysraphisms?
What types of neurological impairments are associated with occult spinal dysraphisms?
How are most open neural tube defects diagnosed?
How are most open neural tube defects diagnosed?
What is the general prevalence of spina bifida among congenital anomalies?
What is the general prevalence of spina bifida among congenital anomalies?
How is a dimple in the lower spine/sacral region related to occult spinal dysraphisms?
How is a dimple in the lower spine/sacral region related to occult spinal dysraphisms?
What condition is believed to be halted or prevented by early neurosurgical intervention?
What condition is believed to be halted or prevented by early neurosurgical intervention?
List two symptoms that may indicate the presence of spinal dysraphism.
List two symptoms that may indicate the presence of spinal dysraphism.
What type of physical anomalies should pediatricians be vigilant about when evaluating for congenital neurologic malformations?
What type of physical anomalies should pediatricians be vigilant about when evaluating for congenital neurologic malformations?
What diagnostic tool is commonly used for evaluating congenital neurologic malformations?
What diagnostic tool is commonly used for evaluating congenital neurologic malformations?
What demographic change has been observed in the prevalence of spina bifida and anencephaly from 1995 to 2002?
What demographic change has been observed in the prevalence of spina bifida and anencephaly from 1995 to 2002?
What is a potential consequence of untreated spinal dysraphism?
What is a potential consequence of untreated spinal dysraphism?
According to research, what evidence supports the importance of identifying cutaneous stigmata in diagnosing spinal conditions?
According to research, what evidence supports the importance of identifying cutaneous stigmata in diagnosing spinal conditions?
What can careful inspection of a population at risk for spinal dysraphism reveal?
What can careful inspection of a population at risk for spinal dysraphism reveal?
What is the primary concern regarding midline skin anomalies in newborns?
What is the primary concern regarding midline skin anomalies in newborns?
What specific skin markings should pediatricians look for during an examination for spinal dysraphism?
What specific skin markings should pediatricians look for during an examination for spinal dysraphism?
How does the identification of suspicious lesions help in the context of spinal dysraphism?
How does the identification of suspicious lesions help in the context of spinal dysraphism?
What can be a consequence of failing to recognize cutaneous markers of spinal dysraphism in infants?
What can be a consequence of failing to recognize cutaneous markers of spinal dysraphism in infants?
What is the significance of cutaneous stigmata in diagnosing congenital neurologic malformations?
What is the significance of cutaneous stigmata in diagnosing congenital neurologic malformations?
Why is an ultrasonographic examination recommended for infants with cutaneous markers?
Why is an ultrasonographic examination recommended for infants with cutaneous markers?
What role do dermal sinuses and capillary hemangiomas play in the assessment of spinal dysraphism?
What role do dermal sinuses and capillary hemangiomas play in the assessment of spinal dysraphism?
What is the prevalence of spina bifida associated with occult spinal dysraphism?
What is the prevalence of spina bifida associated with occult spinal dysraphism?
What is the significance of increased pressure in spinal fluid concerning pediatric care?
What is the significance of increased pressure in spinal fluid concerning pediatric care?
What is the commonly used treatment procedure for managing increased spinal fluid pressure?
What is the commonly used treatment procedure for managing increased spinal fluid pressure?
At what gestational weeks is the optimal time for performing amniocentesis?
At what gestational weeks is the optimal time for performing amniocentesis?
Why is psychosocial support important for families in pediatric neurological care?
Why is psychosocial support important for families in pediatric neurological care?
How does maternal serum analysis relate to neurodevelopmental outcomes in children?
How does maternal serum analysis relate to neurodevelopmental outcomes in children?
What role do surgical interventions play in the management of orthopedic complications related to pediatric conditions?
What role do surgical interventions play in the management of orthopedic complications related to pediatric conditions?
What is one of the key ethical considerations when discussing surgical interventions for pediatric patients?
What is one of the key ethical considerations when discussing surgical interventions for pediatric patients?
What importance does the measurement of Alpha-fetoprotein serve in prenatal care?
What importance does the measurement of Alpha-fetoprotein serve in prenatal care?
What role does alpha-fetoprotein play in prenatal screening?
What role does alpha-fetoprotein play in prenatal screening?
How can orthopedic complications arise in patients with myelomeningocele?
How can orthopedic complications arise in patients with myelomeningocele?
What is the significance of maternal serum alpha-fetoprotein levels?
What is the significance of maternal serum alpha-fetoprotein levels?
What potential neurodevelopmental outcomes are linked to elevated alpha-fetoprotein levels?
What potential neurodevelopmental outcomes are linked to elevated alpha-fetoprotein levels?
What surgical interventions may be necessary for kyphosis in myelomeningocele patients?
What surgical interventions may be necessary for kyphosis in myelomeningocele patients?
What is a potential risk of failing to address elevated maternal serum alpha-fetoprotein levels?
What is a potential risk of failing to address elevated maternal serum alpha-fetoprotein levels?
What is the significance of alpha-fetoprotein (AFP) screening in the context of maternal serum analysis?
What is the significance of alpha-fetoprotein (AFP) screening in the context of maternal serum analysis?
How might orthopedic complications relate to congenital conditions identified through maternal serum analysis?
How might orthopedic complications relate to congenital conditions identified through maternal serum analysis?
How do prenatal screening guidelines aim to manage the risk of fetal defects?
How do prenatal screening guidelines aim to manage the risk of fetal defects?
What potential neurodevelopmental outcomes can arise for infants with congenital conditions identified during pregnancy?
What potential neurodevelopmental outcomes can arise for infants with congenital conditions identified during pregnancy?
What factors can influence the effectiveness of surgical interventions for orthopedic deformities?
What factors can influence the effectiveness of surgical interventions for orthopedic deformities?
In what ways do surgical interventions play a role in managing conditions diagnosed through AFP screening?
In what ways do surgical interventions play a role in managing conditions diagnosed through AFP screening?
How does the presence of false-positive results in maternal serum screenings affect clinical management?
How does the presence of false-positive results in maternal serum screenings affect clinical management?
What are some immediate concerns for newborns diagnosed with conditions like congenital nephrosis or fetal distress?
What are some immediate concerns for newborns diagnosed with conditions like congenital nephrosis or fetal distress?
What role does comprehensive counseling play for parents based on maternal serum analysis results?
What role does comprehensive counseling play for parents based on maternal serum analysis results?
Why is the assessment for reflux important in the context of upper urinary tract dilation detected during screening?
Why is the assessment for reflux important in the context of upper urinary tract dilation detected during screening?
Flashcards
Neural Tube Defects (NTDs)
Neural Tube Defects (NTDs)
Common birth defects that cause infant mortality and disability.
Folic Acid Recommendation
Folic Acid Recommendation
USPHS recommends 400mg of folic acid daily for women of childbearing age.
Prevention Gap
Prevention Gap
A large number of women aren't meeting the recommended dose of folic acid.
NTDs Prevention
NTDs Prevention
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Unplanned Pregnancies
Unplanned Pregnancies
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Neural Tube Closure
Neural Tube Closure
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USPHS Recommendation
USPHS Recommendation
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Folic Acid Intake
Folic Acid Intake
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Folic acid dosage for NTD prevention
Folic acid dosage for NTD prevention
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NTD Reduction
NTD Reduction
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Additional vitamins with folic acid
Additional vitamins with folic acid
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Multivitamins without folic acid
Multivitamins without folic acid
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Lower folic acid dosage study
Lower folic acid dosage study
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360 mg daily folic acid
360 mg daily folic acid
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USPHS and CDC recommendations
USPHS and CDC recommendations
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Evidence evolution for folic acid prevention
Evidence evolution for folic acid prevention
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Folic acid's effect on B12 deficiency
Folic acid's effect on B12 deficiency
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USPHS recommendation for folate intake
USPHS recommendation for folate intake
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IOM tolerable upper intake limit
IOM tolerable upper intake limit
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NTDs risk & folic acid
NTDs risk & folic acid
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Prenatal screening for NTDs
Prenatal screening for NTDs
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Folic acid for NTD history
Folic acid for NTD history
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Folic acid safety studies
Folic acid safety studies
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Pernicious anemia and folic acid
Pernicious anemia and folic acid
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Folic Acid
Folic Acid
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Increased Folic Acid Intake
Increased Folic Acid Intake
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Relatives with NTDs
Relatives with NTDs
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Type 1 Diabetes Mellitus
Type 1 Diabetes Mellitus
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Valproic Acid or Carbamazepine
Valproic Acid or Carbamazepine
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Periconceptional Folic Acid Intake
Periconceptional Folic Acid Intake
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Physician Consultation
Physician Consultation
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Folic Acid Fortification
Folic Acid Fortification
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Vitamin B12
Vitamin B12
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Vitamin A and Birth Defects
Vitamin A and Birth Defects
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Emery and Rimoin’s Principles and Practice of Medical Genetics
Emery and Rimoin’s Principles and Practice of Medical Genetics
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Folic Acid Supplementation
Folic Acid Supplementation
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Food Fortification
Food Fortification
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Surveillance
Surveillance
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Spina Bifida
Spina Bifida
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IOM Recommendation
IOM Recommendation
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Unintended Pregnancy
Unintended Pregnancy
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Adverse Outcomes
Adverse Outcomes
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Increased Folic Acid for NTD History
Increased Folic Acid for NTD History
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NTD Prevention Effectiveness
NTD Prevention Effectiveness
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Who Benefits Most from Folic Acid?
Who Benefits Most from Folic Acid?
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Folic Acid's Role in NTD Prevention
Folic Acid's Role in NTD Prevention
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NTD Prevention: How Much Folic Acid?
NTD Prevention: How Much Folic Acid?
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Folic Acid Intake and NTD Recurrence
Folic Acid Intake and NTD Recurrence
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Folic Acid Supplement vs. Multivitamin
Folic Acid Supplement vs. Multivitamin
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Importance of Early Intake
Importance of Early Intake
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Primary Prevention
Primary Prevention
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Additional Vitamins and NTD Risk
Additional Vitamins and NTD Risk
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Evidence Evolution for Folic Acid
Evidence Evolution for Folic Acid
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Two Folic Acid Recommendations
Two Folic Acid Recommendations
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Anencephaly
Anencephaly
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Periconceptional Period
Periconceptional Period
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Increased Folic Acid Dosage
Increased Folic Acid Dosage
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Folic Acid for NTDs
Folic Acid for NTDs
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Recommended Folic Acid Intake
Recommended Folic Acid Intake
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Folic Acid and Unintended Pregnancies
Folic Acid and Unintended Pregnancies
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Surveillance of Folic Acid Effectiveness
Surveillance of Folic Acid Effectiveness
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Folic Acid's Role
Folic Acid's Role
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Folic Acid for Prevention
Folic Acid for Prevention
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Why Boost Folic Acid?
Why Boost Folic Acid?
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Folic Acid vs. Food Folate
Folic Acid vs. Food Folate
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Folic Acid and B12 Deficiency
Folic Acid and B12 Deficiency
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Unplanned Pregnancies and Folic Acid
Unplanned Pregnancies and Folic Acid
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Folic Acid Safety
Folic Acid Safety
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Folic Acid and Other Vitamins
Folic Acid and Other Vitamins
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Occult Spinal Dysraphism (OSD)
Occult Spinal Dysraphism (OSD)
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Split Cord Malformation
Split Cord Malformation
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Dermal Sinus Tract
Dermal Sinus Tract
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Tethered Spinal Cord
Tethered Spinal Cord
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Intraspinal Lipoma
Intraspinal Lipoma
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What's the difference between Spina Bifida Occulta (SBO) and Occult Spinal Dysraphisms (OSDs)?
What's the difference between Spina Bifida Occulta (SBO) and Occult Spinal Dysraphisms (OSDs)?
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How are OSDs diagnosed?
How are OSDs diagnosed?
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What are the signs of an OSD?
What are the signs of an OSD?
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Spinal cord tethering
Spinal cord tethering
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Early neurosurgical intervention
Early neurosurgical intervention
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Neurological deficits
Neurological deficits
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Midline skin anomalies
Midline skin anomalies
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Cutaneous stigmata
Cutaneous stigmata
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Pediatrician's role in detecting spinal cord issues
Pediatrician's role in detecting spinal cord issues
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Importance of vigilance for spinal cord tethering
Importance of vigilance for spinal cord tethering
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Spinal cord tethering and neurological deficits
Spinal cord tethering and neurological deficits
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Why are midline skin anomalies important?
Why are midline skin anomalies important?
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What to look for in newborns?
What to look for in newborns?
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Dermal Sinuses
Dermal Sinuses
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Coccygeal Pits
Coccygeal Pits
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Ultrasound for OSD
Ultrasound for OSD
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Importance of Early Diagnosis
Importance of Early Diagnosis
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Kyphosis
Kyphosis
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Myelomeningocele
Myelomeningocele
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False-positive Results
False-positive Results
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Alpha-feto-protein
Alpha-feto-protein
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Prenatal Detection
Prenatal Detection
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Triage
Triage
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Neural Tube Defects
Neural Tube Defects
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Vigorous Treatment
Vigorous Treatment
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Pediatrician's Role
Pediatrician's Role
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Importance of Vigilance
Importance of Vigilance
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What makes managing neural tube defects challenging?
What makes managing neural tube defects challenging?
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Why are false-positive results a concern in NTD diagnosis?
Why are false-positive results a concern in NTD diagnosis?
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What are some conditions that mimic NTDs?
What are some conditions that mimic NTDs?
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What is the current approach to managing NTDs?
What is the current approach to managing NTDs?
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Why is counseling important for NTD patients and families?
Why is counseling important for NTD patients and families?
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What is the Credé maneuver?
What is the Credé maneuver?
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What is the significance of folic acid in NTD prevention?
What is the significance of folic acid in NTD prevention?
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What is the recommended daily intake of folic acid?
What is the recommended daily intake of folic acid?
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Study Notes
Folic Acid for the Prevention of Neural Tube Defects
- Folic acid consumption (400 µg daily) is recommended for all women capable of becoming pregnant to prevent neural tube defects (NTDs).
- Studies show folic acid can prevent 50% or more of NTDs like spina bifida and anencephaly.
- For women with a history of NTD-affected pregnancies, the CDC recommends a higher intake (4000 µg daily) at least one month before conception and throughout the first trimester.
- NTDs are common birth defects causing infant mortality and disability, occurring in approximately 1 in 1000 births in the US.
- About 2500 infants are born with NTDs each year.
- Periconceptional folic acid supplementation can prevent over half of NTDs.
- USPHS and CDC recommendations were developed based on multiple studies demonstrating the prevention of NTDs.
- Approximately half of US pregnancies are unplanned, and neural tube closure occurs during the first four weeks of gestation.
- Despite recommendations from September 1992, only 30% of women aged 18-45 follow them in 1998.
- The recurrence risk for NTDs in subsequent pregnancies of women with a previous affected child is 2-3%.
- A 1991 Medical Research Council (MRC) trial conclusively demonstrated that 4000 µg of folic acid significantly reduced NTD recurrence by 71%.
- A UK study suggested a possible comparable reduction with a lower dosage (360 µg daily), but this was not a randomized controlled trial.
- No adverse maternal or fetal effects from 4000 µg folic acid were detected in a large study.
- Folic acid is a synthetic compound, and the term "folate" encompasses naturally occurring similar compounds.
- Average US diets contain 200 µg of naturally occurring folate, which is less bioavailable than folic acid.
- Increased consumption of food folate hasn't been proven as effective as folic acid supplements in NTD prevention.
- Folic acid has no known toxicity.
- A higher dose can correct vitamin B12 deficiency anemia but doesn't prevent the neurologic consequences of vitamin B12 deficiency. A safe upper limit is 1000 µg (synthetic folic acid) daily.
- Most multivitamin preparations contain 400 µg folic acid, and folic acid tablets are available over the counter in dosages up to 800 µg. 1000 µg tablets are prescription-only.
- Enriched cereal-grain products are mandated to be fortified with 140 µg folic acid per 100g of flour.
- The recommendation advises women to consume 400 µg of folic acid daily via multivitamins or folic acid supplements in addition to a healthy diet.
- Women with a prior NTD-affected pregnancy should consume 4000 µg daily starting one month prior to planned pregnancy and throughout the first 3 months.
Recommendations
- Women with no prior NTD-affected pregnancy: Consume 400 µg folic acid daily, preferably in a multivitamin.
- Women with prior NTD-affected pregnancy: Consume 4000 µg folic acid daily, 1 month before conception and throughout the first 3 months.
- Other high-risk groups: Consult with a physician regarding potential risks and benefits of increased folic acid intake. This includes close relatives with NTDs, type 1 diabetes, or seizure disorders.
Public Health Programs (Additional Considerations)
- Educational programs, food fortification, and monitoring programs are needed to implement and maintain folic acid recommendations effectively.
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Description
This quiz covers the vital role of folic acid in preventing neural tube defects (NTDs) in pregnant women. It discusses recommended dosages, the impact of supplementation on NTD occurrence, and the CDC guidelines for women with a history of NTD-affected pregnancies. Understanding these facts is crucial for promoting maternal and infant health.
