Folate status in women of reproductive age as basis of neural tube defect risk assessment

Folate status in women of reproductive age as basis of neural tube defect risk assessment Reliable folate status data for women of reproductive age (WRA) to assess global risk for neural tube defects (NTDs) are needed. We focus on a recent recommendation by the World Health Organization that a specific “optimal” red blood cell (RBC) folate concentration be used as the sole indicator of NTD risk within a population and discuss how to best apply this guidance to reach the goal of assessing NTD risk globally. We also emphasize the importance of using the microbiologic assay (MBA) as the most reliable assay for obtaining comparable results for RBC folate concentration across time and countries, the need for harmonization of the MBA through use of consistent key reagents and procedures within laboratories, and the requirement to apply assay‐matched cutoffs for folate deficiency and insufficiency. To estimate NTD risk globally, the ideal scenario would be to have country‐specific population‐based surveys of RBC folate in WRA determined utilizing a harmonized MBA, as was done in recent studies in Guatemala and Belize. We conclude with guidance on next steps to best navigate the road map toward the goal of generating reliable folate status data on which to assess NTD risk in WRA in low‐ and middle‐income countries. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annals of the New York Academy of Sciences Wiley

Folate status in women of reproductive age as basis of neural tube defect risk assessment

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 The New York Academy of Sciences
ISSN
0077-8923
eISSN
1749-6632
D.O.I.
10.1111/nyas.13511
Publisher site
See Article on Publisher Site

Abstract

Reliable folate status data for women of reproductive age (WRA) to assess global risk for neural tube defects (NTDs) are needed. We focus on a recent recommendation by the World Health Organization that a specific “optimal” red blood cell (RBC) folate concentration be used as the sole indicator of NTD risk within a population and discuss how to best apply this guidance to reach the goal of assessing NTD risk globally. We also emphasize the importance of using the microbiologic assay (MBA) as the most reliable assay for obtaining comparable results for RBC folate concentration across time and countries, the need for harmonization of the MBA through use of consistent key reagents and procedures within laboratories, and the requirement to apply assay‐matched cutoffs for folate deficiency and insufficiency. To estimate NTD risk globally, the ideal scenario would be to have country‐specific population‐based surveys of RBC folate in WRA determined utilizing a harmonized MBA, as was done in recent studies in Guatemala and Belize. We conclude with guidance on next steps to best navigate the road map toward the goal of generating reliable folate status data on which to assess NTD risk in WRA in low‐ and middle‐income countries.

Journal

Annals of the New York Academy of SciencesWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

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