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Kikuchi D, Obara T, Usuzaki T, Yonezawa Y, Yamashita T, Oyanagi G, Noda A, Ueno F, Murakami K, Matsubara H, Ishikuro M, Metoki H, Kikuya M, Kuriyama S. Evaluating folic acid supplementation among Japanese pregnant women with dietary intake of folic acid lower than 480 µg per day: results from TMM BirThree Cohort Study. J Matern Fetal Neonatal Med 2020; 35:964-969. [PMID: 32166991 DOI: 10.1080/14767058.2020.1739020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: In Japan, supplementation with 400 µg of folic acid per day is recommended for women who are planning to get pregnant to decrease the risk of their babies getting neural tube defects (NTD). However, the proportion of women who have taken folic acid supplements before conception is low among Japanese pregnant women. In addition, the dietary intake of folic acid has not yet reached the government recommended dietary intake levels (480 µg per day). This study aimed to clarify the prevalence and determinants of adequate folic acid supplements among Japanese pregnant women with dietary folic acid intake lower than 480 µg per day.Methods: This cross-sectional study was a part of the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. We collected information on folic acid supplements before conception, sociological/lifestyle characteristics, and food consumption. The primary outcome was the use of folic acid supplements (adequate or inadequate, based on the timing of initiation of folic acid supplements). Multiple logistic regression analysis was used to examine the association between sociological/lifestyle characteristics and the adequate intake of folic acid supplements.Results: Among the 11,562 pregnant women who took lower than 480 µg per day of folic acid from food, the prevalence of adequate users was 18.0%. Pregnant women who reported adequate use of folic acid supplements were more likely to be older and educated; and reported higher household income, and history of fertility treatment. Conversely, they were less likely to be ever or current smokers and multipara.Conclusion: This study found that the prevalence of folic acid supplements use for the prevention of NTD among Japanese pregnant women was still low.
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Affiliation(s)
- Daisuke Kikuchi
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Obara
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Takuma Usuzaki
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yudai Yonezawa
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Innovation Division, Kagome Co., Ltd, Nasushiobara, Japan
| | - Takahiro Yamashita
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Innovation Division, Kagome Co., Ltd, Nasushiobara, Japan
| | - Gen Oyanagi
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Aoi Noda
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Fumihiko Ueno
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Keiko Murakami
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Hiroko Matsubara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Mami Ishikuro
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Masahiro Kikuya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Shinichi Kuriyama
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
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Kondo A, Akada S, Akiyama K, Arakawa M, Ichi S, Inamoto Y, Ishida T, Ishikawa H, Itoh T, Izumi A, Kimura F, Kondo AS, Matsuoka R, Miyauchi A, Mochizuki J, Momohara Y, Morikawa S, Morioka M, Morota N, Nakabe K, Obayashi S, Oku M, Samura O, Sasahara J, Sase M, Shimamoto K, Shimamura K, Sumigama S, Tada K, Takahashi H, Tani A, Wada S, Wada-HIraike O, Watanabe T, Yamaguchi M, Yasui T, Yokomine M. Real prevalence of neural tube defects in Japan: How many of such pregnancies have been terminated? Congenit Anom (Kyoto) 2019; 59:118-124. [PMID: 30883906 DOI: 10.1111/cga.12333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 03/08/2019] [Accepted: 03/14/2019] [Indexed: 12/30/2022]
Abstract
The vital role of folic acid is to reduce the risk of having a neonate afflicted with neural tube defects. The prevalence of neural tube defects (myelomeningocele and anencephaly) has been reported in an incomplete form over the last 40 years in Japan. We aimed to evaluate the total number of neural tube defects including those delivered or terminated, to clarify the proportion of those terminated, and to internationally compare their prevalence. Through information on >311 000 deliveries obtained from 262 hospitals/clinics for 2 years of 2014 and 2015, we identified that the rate of total neural tube defects (termination of pregnancy, live births and stillbirths) was 8.29 per 10 000 deliveries for the year 2014 and was 8.72 for 2015, which were 1.5 and 1.6 times higher than the respective values (live births and stillbirths) reported. It is also observed that the ratio of the total number of myelomeningocele (termination of pregnancy, live births, and stillbirths) to that of anencephaly was approximately 1:1.2, that a half of pregnancies afflicted with neural tube defects were terminated, and that the proportion of termination of pregnancy due to myelomeningocele and due to anencephaly was 20% and 80%, respectively. Internationally, the real prevalence of neural tube defects in Japan was comparatively high, ranking fifth among the seven developed countries. In conclusion, the real prevalence of total neural tube defects was approximately 1.5 times higher than that currently reported by the Japan Association of Obstetricians and Gynecologists.
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Affiliation(s)
- Atsuo Kondo
- Department of Urology, Atsuta Rehabilitation Hospital, Nagoya, Japan
| | - Shinobu Akada
- Department of Obstetrics and Gynecology, Osaka Habikino Medical Center, Habikino
| | - Kunihisa Akiyama
- Department of Obstetrics and Gynecology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan
| | | | - Shunsuke Ichi
- Department of Neurosurgery, Japanese Red Cross Hospital, Tokyo, Japan
| | - Yutaka Inamoto
- Department of Obstetrics and Gynecology, JA Shizuoka Kohseiren Enshu Hospital, Hamamatsu, Japan
| | - Tomohiko Ishida
- Department of Obstetrics and Gynecology, Itabashi Chuo Medical Center, Tokyo, Japan
| | - Hiroshi Ishikawa
- Department of Obstetrics and Gynecology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Tomonori Itoh
- Department of Internal Medicine, Atsuta Rehabilitation Hospital, Nagoya, Japan
| | | | - Fuminori Kimura
- Department of Obstetrics and Gynecology, Shiga University of Medical Science Hospital, Ohtsu, Japan
| | - Atsuya S Kondo
- Department of Urology, Kariya Toyota General Hospital, Kariya, Japan
| | - Ryu Matsuoka
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan
| | - Akito Miyauchi
- Department of Obstetrics and Gynecology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Junko Mochizuki
- Department of Obstetrics and Gynecology, Kitasato University Hospital, Sagamihara, Japan
| | - Yoshihito Momohara
- Department of Obstetrics and Gynecology, Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan
| | - Shigehiko Morikawa
- Department of Obstetrics and Gynecology, Komaki Municipal Hospital, Komaki, Japan
| | - Miki Morioka
- Department of Obstetrics and Gynecology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Nobuhito Morota
- Department of Neurosurgery, Kitasato University Hospital, Sagamihara, Japan
| | | | - Satoshi Obayashi
- Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Medical Hospital, Tokyo, Japan
| | - Masataka Oku
- Department of Obstetrics and Gynecology, Higashiosaka City Medical Center, Higashiosaka, Japan
| | - Osamu Samura
- Department of Obstetrics and Gynecology, The Jikei University Hospital, Tokyo, Japan
| | - Jun Sasahara
- Department of Obstetrics and Gynecology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan
| | - Masakatsu Sase
- Department of Obstetrics and Gynecology, Yamaguchi Prefectural Grand Medical Center, Houhu, Japan
| | - Kumi Shimamoto
- Department of Obstetrics and Gynecology, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Katsunori Shimamura
- Department of Obstetrics and Gynecology, Yamaguchi-ken Saiseikai Shimonoseki General Hospital, Shimonoseki, Japan
| | - Seiji Sumigama
- Department of Obstetrics and Gynecology, Nagoya University Hospital, Nagoya, Japan
| | - Katsuhiko Tada
- Department of Obstetrics and Gynecology, Okayama Medical Center, Okayama, Japan
| | - Hiroyuki Takahashi
- Department of Obstetrics and Gynecology, Tottori Prefectural Central Hospital, Tottori, Japan
| | | | - Seiji Wada
- Division of Fetal Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Osamu Wada-HIraike
- Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, Japan
| | - Tomoyuki Watanabe
- Department of Nutritional Science, Aichi Gakuin University, Nisshin, Japan
| | - Masatoshi Yamaguchi
- Department of Obstetrics and Gynecology, University of Miyazaki Hospital, Miyazaki, Japan
| | - Tomoyo Yasui
- Department of Obstetrics and Gynecology, Osaka City University Hospital, Osaka, Japan
| | - Masato Yokomine
- Department of Obstetrics and Gynecology, Kurume University Hospital, Kurume, Japan
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Nishigori H, Obara T, Nishigori T, Ishikuro M, Sakurai K, Hoshiai T, Saito M, Fujiwara I, Arima T, Nakai K, Kuriyama S, Mano N, Metoki H, Yaegashi N, Saito H, Kishi R, Yaegashi N, Hashimoto K, Mori C, Ito S, Yamagata Z, Inadera H, Kamijima M, Nakayama T, Iso H, Shima M, Hirooka Y, Suganuma N, Kusuhara K, Katoh T. Preconception folic acid supplementation use and the occurrence of neural tube defects in Japan: A nationwide birth cohort study of the Japan Environment and Children's Study. Congenit Anom (Kyoto) 2019; 59:110-117. [PMID: 29900595 DOI: 10.1111/cga.12293] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 06/04/2018] [Accepted: 06/04/2018] [Indexed: 12/14/2022]
Abstract
We evaluated the relationship between preconception folic acid supplementation and the occurrence of neural tube defects (NTDs) in offspring, using data from the Japan Environment and Children's Study (a nationwide prospective birth cohort study) database. Of 92 269 participants with single pregnancies, 74 cases (offspring or fetuses) had NTDs, including 32 cases of spina bifida, 24 cases of anencephaly, and 19 cases of encephalocele. A total of 7634 participants (8.27%) used preconception folic acid supplementation, and of these, 621 (0.67%) also took in dietary folic acid at ≥480 μg/day. Multivariate logistic regression analyses demonstrated no association between preconception folic acid supplementation and NTDs in offspring or fetuses (odds ratio [OR] 0.622; 95% confidence interval [CI]: 0.226-1.713). Moreover, the participants who combined preconception folic acid supplement use with dietary folic acid intake ≥480 μg/day demonstrated no incidence of NTDs in offspring or fetuses. Our analysis is limited by the absence of the data on the daily amount of supplementary folic acid intake, requiring careful attention to the interpretation. Additional surveys are required in Japan to resolve those limitations for further comprehensive assessment.
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Affiliation(s)
- Hidekazu Nishigori
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.,Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Taku Obara
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.,Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Miyagi, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
| | - Toshie Nishigori
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
| | - Kasumi Sakurai
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Tetsuro Hoshiai
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Masatoshi Saito
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Ikuma Fujiwara
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Takahiro Arima
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Kunihiko Nakai
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Shinichi Kuriyama
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,International Research Institute for Disaster Science, Tohoku University, Sendai, Miyagi, Japan
| | - Nariyasu Mano
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.,Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | | | - Hirohisa Saito
- National Center for Child Health and Development Tokyo Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Koichi Kusuhara
- University of Occupational and Environmental Health Kitakyushu Japan
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4
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The Japanese Teratology Society declares "Folic Acid Awareness Day" and "Neural Tube Defect Prevention Month". Congenit Anom (Kyoto) 2019; 59:108-109. [PMID: 31008540 DOI: 10.1111/cga.12337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 03/28/2019] [Indexed: 11/29/2022]
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