Author/Editor | Pušenjak, Stanko; Salobir-Gajšek, Uršula; Novak-Antolič, Živa; Tul, Nataša | |
Title | Preprečevanje nepravilnosti v razvoju nevralne cevi pri plodu | |
Translated title | Preventing of fetal neural tube defects | |
Type | članek | |
Source | Zdrav Vars | |
Vol. and No. | Letnik 37, št. 11-12 | |
Publication year | 1998 | |
Volume | str. 521-2 | |
Language | slo | |
Abstract | Congenital defects are among the most important causes of perinatal morbidity and mortality in developed contries. In Slovenia, the incidence of congenital fetal neural tube defects (NTD) during 1987 and 1995 was 0,56/1000 liveborn infants. Neural tube anomaly is the second most frequent big fetal anomaly immediately following congenital heart defects. In 85% it is an isolated anomaly with no additional anomalies. It arises between 24th and 27th day of embrional development at the time of neural tube closure. Among the causes for NTD, the most important are genetic factor and relative deficiency of folic acid which can be due to the lack of folates in food or can be caused iatrogenically at the administrtion of antifolate drugs. Synthetic preparations of monoglutamic folic acid are more effective than foliate food. Among the most important researches which proved the usefullness of adding folic acid to the food of pregnant women is the Vitamin Study Research Group on the British Medical research Council in the years 1983 - 1991, performed as double blindrandomized and prospective. It proved that folic acid prevents NTD in 72%. In USA, Food and Drug Administration (FDA) has achieved the passing of law which obliges the food producers to add folic acid to all the cereals. Only so it is possible to provide the majority of women in time with the sufficient quantity of folic acid in the time of conception and during the embryonal phase of fetus development. | |
Summary | Prirojene nepravilnosti so med najpomembnejšimi vzroki perinatalne obolevnosti in umrljivosti v razvitih državah. V Sloveniji je bila incidenca prirojenih nepravilnosti nevralne cevi med letoma 1987 in 1995 0,56/1000 rojenih otrok (1). Anomalija nevralne cevi (NTD) je druga najpogostejša velika anomalij apri plodu takoj za prirojenimi srčnimi hibami. V 85% je tak anomalija osamljena, brez dodatnih anomalij. Nastane med 24. in 27. dnem embrionalnega razvoja, ko se nevtralna cev zapira. Med vzroki za NTD sta najpomembnejša genetski dejavnik in relativno pomanjkanje folijske kisline, kar lahko nastane zaradi pomanjkanja folatov v prehrani ali iatrogeno po jemanju antifolatnih zdravil. Pripravki sintetičnih oblik monoglutamatne folijske kisline so bolj učinkovit kot listnata prehrana. Med najpobmemenejše raziskave, ki so dokazale koristnost dodajanja folijske kisline prehrani nosečnic, sodi Vitamin Study Research Group na British Medical Research Council (MRC) v letih 1983-1991, ki je bila izvedena dvojno slepo randomizirano in prospektivno. Dokazala je, da folijska kislina prepreči NTD v 72% (4). Uprava za hrano inzdravila (FDA) je v ZDA dosegla sprejem zakona, po katerem morajo proizvajalci živil vsem žitaricam dodajati folijsko kislino. Le tako je mogoče večino žensk pravočasno preskrbeti z zadostno količino folijske kisline v času zanositve in v embrionalni fazi razvoja ploda. | |
Descriptors | NEURAL TUBE DEFECTS FOLIC ACID |