Protective Effect of Folic Acid Supplementation in Preventing NTDs

This review was focused on examining if the periconceptional folate supplementation can aid in reducing the risk of neural tube defects among other congenital anomalies, including cleft palate on either the mothers or their babies. The results of the review evidenced that there is a protective effect on both mothers and babies, of folic acid supplementation in preventing NTDs. In this case, the acids could either be taken alone or in combination with other minerals or vitamins. The results were compared to the poor results obtained when women used interventions of NTDs with no form of placebo or minerals and vitamins without any folic acids.

Background

From the birth defects research conducted in the past, it has been ascertained that Neural Tube Defects (NTD), can be avoided by using periconceptional folic acids. Daily consumption of folic acid doses can aid in preventing the Spina Bifida and anencephaly, which are two of the most common birth defects. Women who are at a childbearing age are recommended to use 0.4 mg (400 micrograms) of folic acids, before and during their early pregnancy period. This consumption is recommended for persons aged between 15 and 45 years. Nevertheless, the effects of different doses, schemes, as well as forms of folate supplementation aimed at prevention of the common birth effects, infant as well as maternal outcomes, are unclear.

Focused Review

Question Does periconceptional folate supplementation aid in minimizing the risks of neural tube defects among other congenital anomalies on both mothers or babies?

The core focus of this review is to determine whether periconceptional folate supplementation can significantly reduce the risks of neural tube defects among other congenital anomalies including cleft palate on either mothers and babies

Population The population to be used in this research include 70 women aged between 15 and 45. The reason for using this number of persons is to enable the research to have sufficient samples for analysis while at the same time not exceeding the sample population with which the available review resources can handle. In addition, the rationale for using women aged 15 and 45 is because they are all at their most productive period of pregnancy and also highly susceptible to attaining NTD complications CITATION CDC16 \l 1033 (CDC, 2016).

Interventions and Comparators Supplementation of the women with any form of folate compared to when no intervention, no other micronutrients without folate and no placebo is offered to other women.

Supplementation of the women with folic acid alone compared to when no treatment or placebo is offered to other women.

Supplementation of the women with folate and other micronutrients with folate compared to supplementation of other women with other micronutrients without folate

supplementation of the women with folate plus other micronutrients with folate compared to the supplementation of other women with the same other micronutrients without folate

Search Strategy

Terms Thesaurus Free-Text

Population

Women female gender. Pregnant expecting a child. The research will consider pregnant women between age 15 and 45.

Intervention (s)

Folic acid dose supplements containing folate compounds.

The women will be offered folic acid doses during the research.

[Outcomes]

[Comparators]

Search Limits

Study Designs There will only be two limits for this research, humans and women/females likely to be affected by NTDs.

Type of Publications Not Applicable

Date of Publication Not Applicable

Language Not Applicable

Other Limits Not Applicable

Sources to Be Used for the Search

Electronic Database NCBI Resources Database, Medline, Cochrane Library, EMBASE, EBSCOhost, HAPI and CINAHL.

Grey Literature National Library of Medicine Conference Proceedings

Other Sources NIH U.S. National Library of Science

Methods for Handling Citations and Selecting Studies. The citations will be handled using Aigaion, which is a citation handling software developed by Aigaion Developers in 2005. It is a free or open source software licensed under GPL and GNU.

There will be five reviewers involved in the citations sifting and selection process.

Possible exclusions will be made at the abstract stage, and potentially relevant studies will be obtained at full-text for further screening.

Inclusion and Exclusion Criteria for Studies

Selection Criteria Inclusion Exclusion

Population

The population to be used will be 70 women aged from 15 to 45. Women who will either be in their 2nd or 3rd trimesters of pregnancy will not be included in the study.

Intervention

Oral folate supplements will be offered to patients combined with other vitamins and minerals. They will be offered on either daily or intermittent basis. No exclusion

Comparators

The results will be compared to results attained from absorbing placebo, other minerals and vitamins with no folate as well as results attained with the absence of supplementation. None exclusion

Outcomes

Not yet determined Not yet determined

Study type

The types of studies which will be used in this review will include the quasi-randomized study, and the cluster randomized study. No exclusion

Language

Not applicable Not applicable

Quality Assessment Strategy

To quality assessment tool to be used in this research will include the Quantitative Research Assessment Tool. The tool will fit the quasi and randomized type of study. Quantitative research uses numbers in order to interpret the various data attained from a research study (Maki, 2004).

Data Extraction

During the study, a digital form will be developed to extract data and record information on the study settings as well as all the participants of the research. The electronic form will also be used to record the imminent risks of biases of the research as well as the methods used to carry out the research. All the data to be placed in the data extraction template will be attained from credible online sources.

The extracted data will then be entered in the Review Manager Software (RevMan). The software will be employed to check for the accuracy of the collected data and later all the discrepancies attained will be solved through discussion. In the event there is some information that will appear to be unclear from the research, a clarification will be attained by contacting the original authors of the research publications.

Proposed Data Synthesis

In this review, there will be no dichotomous data since all participants are females. However, the data will be considered as continuous and measured on a continuum or scale. In this case, the scale will be subdivided into finer increments illustrating the occurrence of NTDs due to the supplementation of folic acid doses, other nutrients and vitamins with folates, as well as non-folate vitamins and others nutrients. I will subject all data signifying statistical heterogeneity to further analysis using an I-Squared cutoff. In addition, due to the manageable number of samples in the population, it is not expected to occur any missing data. In the priori sensitivity and priori sub-group analysis, I plan to include the posthoc sensitivity analysis, all corresponding rationale, results as well as the discussion of the consequences of the factors to be reviewed on the final findings of the research.

Review Timetable Template

Task Completion date

Focus question 10/06/2016

Draft protocol 15/06/2016

Scoping search 25/06/2016

Final protocol 10/07/2016

Full searches 15/06/2016

Order papers 25/06/2016

Study selection 01/08/2016

Quality assessment 10/08/2016

Data extraction 15/08/2016

Data synthesis 25/08/2016

Draft review submission 01/09/2016

Final review submission 10/09/2016

References

BIBLIOGRAPHY CDC. (2016, April 21). Folic Acid. Retrieved June 27, 2016, from Centers for Disease Control and Prevention CDC: https://www.cdc.gov/ncbddd/folicacid/recommendations.html

Maki, P. L., (2004). Assessing for learning: Building a sustainable commitment across the institution Sterling, VA: Stylus.