Prevention

In the context of the prevention of NTDs, it is necessary to distinguish between primary and secondary prevention. Primary prevention concerns measures that prevent the development of NTD in the embryo. Secondary prevention refers to screening and termination of affected pregnancies. Primary prevention became a reality following the demonstration of the efficacy of folic acid in preventing NTDs and represented a major public health breakthrough.

A substantial body of research shows that taking extra folate/folic acid before conception and during the early months of pregnancy prevents approximately 50-75% of NTDs and is effective in preventing both occurrent and recurrent NTDs. For all women who may become pregnant, it is recommended that they take an extra 0.4 mg of folic acid per day for the primary prevention of NTDs. This is in addition to the usual dietary folate intake, which is estimated to be, on average, approximately 0.2 mg per day in the United Kingdom. The most effective ways of using this knowledge to reduce the number of NTD births are discussed next.

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