Dietary Approaches to the Prevention of Neural Tube Defects
1983
Laurence, K. M.
Two dietary studies are reported on women resident in Glamorgan and Gwent who had had a child with a neural tube defect (NTD). In the first study the contemporaneous inter-pregnancy and pregnancy diets of 415 women were recorded. Blood samples were taken and analysed for folates and vitamin B12. The quality of the diets correlated with the serum and red cell folate concentrations. The diets during the subsequent pregnancy were worse than the inter-pregnancy diet. Half of the women, selected on a geographical basis were advised to improve their diet before and during the next pregnancy. Of these women 174 reported 186 pregnancies in time for a further diet study. Of the women counselled to improve their diet 75% had done so, compared to 10% of those not counselled. There were 8 recurrences of NTD in 186 pregnancies, all the 8 mothers receiving a poor diet during the first 3 months of pregnancy. In the second study the interpregnancy diets of 244 women who had had a child with a NTD were compared to the diets of their own sisters and a group of professional women. The diet of the index cases was worse than that of either control group. 5 mothers who had poor diets during the first 3 months of the pregnancy had a child with a NTD. It is concluded that women on a better diet during the first trimester have a lower risk of NTD recurrence. Dietary counselling can be effective in improving the diet in women at increased risk for NTD. Improvement in the diet of prospective mothers by dietary education at school should not be neglected. The relationship between improvements in diet, folic acid and vitamin supplementation, in the prevention of recurrence of NTD is discussed.
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