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Racial Disparity Seen in US Spina Bifida Decline

Since 1999, birth prevalence has significantly declined only in infants born to black mothers

MONDAY, Jan. 12 (HealthDay News) -- The U.S. Food and Drug Administration mandate to add folic acid to all enriched cereal grain products by January 1998 has led to a significant decrease in the prevalence of spina bifida among non-Hispanic black mothers but not among other racial/ethnic groups, according to a report published Jan. 9 in the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

CDC researchers compared the number of spina bifida cases during four periods relative to the January 1998 acid mandate: prefortification (1995-1996), early postfortification (1999-2000), mid-postfortification (2001-2002) and recent postfortification (2003-2005).

Between 1999-2000 and 2003-2005, the researchers found that the overall birth prevalence of spina bifida decreased by 6.9 percent (from 2.04 to 1.90 cases per 10,000 live births). While no significant decreases were observed among infants born to either non-Hispanic white or Hispanic mothers, among non-Hispanic black mothers, the prevalence decreased by 19.8 percent (from 2.17 to 1.74 cases per 10,000 live births).

"Future public health efforts to reduce the prevalence of spina bifida should focus on subgroups of women with known risk factors for a neural tube defect-affected pregnancy, such as obesity, Hispanic ethnicity and certain genetic factors," according to an accompanying editorial note. "Additional study of genetic and environmental risk and protective factors is warranted."

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