Report: Folic acid fortification in Europe could halve rates of birth defects and infant mortality

Woodruff Health Sciences Center | Sept. 2, 2015

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Melva Robertson
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melva.robertson@emory.edu

A recent report co-authored by epidemiologists at the Rollins School of Public Health at Emory University and scientists in Europe has documented a highly preventable epidemic of two major birth defects — spina bifida and anencephaly — in Europe.  The authors report the epidemic is caused by the failure of European governments to require mandatory folic acid fortification.    

Spina bifida and anencephaly are severe birth defects that affect the spinal cord and brain.  Mandatory folic acid fortification of staple foods like wheat or other grain flours is a proven, safe and cost-effective public health intervention that has been preventing spina bifida and anencephaly in the United States and Canada for the last 15 years.

According to the report, about 5,000 European children have had preventable life altering, paralyzing, and often fatal birth defects due to the government’s failure to require mandatory folic acid fortification. Incorporating this intervention to reach all women of childbearing potential, without any behavior modification can reduce the number of birth defects by nearly half.

"It is indeed sad that the children and families in Europe are not benefitting from this proven, safe, and inexpensive public health program of mandatory folic acid fortification," says Godfrey Oakley, MD, MSPM, an author of the study and a professor of epidemiology at the Rollins School of Public Health.

Findings also suggest that children born with abnormalities of the brain and spinal cord entail major social and financial burdens.

"Germany alone has the highest number of births per year in Europe and about 500 cases of spina bifida each year, a majority of which could be prevented if mandatory folic acid fortification were introduced", says co-researcher Vijaya Kancherla, PhD, a birth defects epidemiologist and instructor at Rollins School of Public Health’s Department of Epidemiology.  "For the year 2009, the report shows that fortification would provide an estimated savings of about 33 million Euros in averted lifetime medical care costs for those living with spina bifida."

Complete findings of this study titled "Preventable spina bifida and anencephaly in Europe" are available in an online edition of Birth Defects Research Part A – Clinical and Molecular Teratology.