EFFECT OF FOLIC ACID USE DURING PREGNANCY ON NEURAL TUBE DEFECTS

Аннотация

Neural tube defects (NTDs) are a group of severe birth defects in the development of the central nervous system of thefetus. Studies have shown that adequate folic acid intake before and during the first weeks of pregnancy significantly reduces the risk of these defects. This article reviews the biological role of folic acid, the pathogenesis of NTDs, possible risk factors, andtheresults of preventive folicacid administration. Keywords: folicacid, neural tubedefect, pregnancy, prevention, spinabifida, anencephaly Neural tube defects (NTDs) are congenital abnormalities that occur when the central nervous system fails to close completely during the embryonic period, including spina bifida, anencephaly, and encephalocele. NTDs develop during the 3rd to 4th week of pregnancy, when mostwomen are unaware they are pregnant. More than 300,000 babies are born with NNC each year worldwide. Studies show that taking folicacid before andduring pregnancy can prevent upto 50–70%of thesecases. The purpose of the article is to analyze the importance of folic acid in preventing neural tube defects based onscientificsources and toevaluate approaches in thisregard in Uzbekistan. Information sources:  Recommendations published by WHO, CDC, PubMed, UpToDate, and the Uzbek National Instituteof Health (2010–2024);  Morethan 20clinical studies and meta-analyses related to NNN. Criteria evaluated:  Theeffect offolicacid onfetal development;  Therate ofdevelopment andreduction ofNNN;  Prophylacticdoses and duration oftheiruse. Effects offolic acid: Factor Result 400–800 mcg offolicacid daily Reduces therisk ofIDU by50–70% Along withadditional vitamin B12 Theeffect willincrease further. Starting1month before pregnancy Themost effective protection is provided https://ijmri.de/index.php/jmsi volume 4,issue6,2025 114 Research results:  MRCVitamin Study (1991): In a group of women who took folicacid before pregnancy, theincidence ofspinabifidawas reduced by72%.  WHO recommendation: Every woman planning a pregnancy should take at least 400 mcg offolicacid per day.  Uzbekistan surveillance (2021): Only 38% of women consumed folic acid before pregnancy. Folic acid (vitamin B9) plays an important role in DNA synthesis and cell division. In the early weeks of embryonic development — especially during the neural tube closure process — a deficiency ofthis vitamincan cause severe defects. Themain risk factors forthe development of NNNare:  Folicacid deficiency;  Mothertaking diabetes or anti-epilepticmedications;  Racial factors (ifNNN was observed inthefirst child);  Socioeconomicdisadvantage. Also,while it's important to get folicacid through ahealthy diet, it's not enough—supplements in pillform are more biologically beneficial. In developed countries, folic acid is now mandatory added to bread and flour products (fortification). Thisapproach has significantly reduced theincidence ofIBD. In Uzbekistan, this requires public awareness, planned pregnancies, and widespread implementationof preventive recommendationsbydoctors. Folic acid is one of the most important preventive measures during pregnancy. Taking it before andin thefirst weeks ofpregnancy prevents neural tube defects. Recommendations:  Every woman of childbearing age (if planning) should be recommended a minimum of 400mcg/day offolic acid;  In women with recurrent NNN —increasing the doseto 4mg/day isconsidered;  The healthcare system should introduce the practice of free provision of pregnancy planningand nutritional supplements;  Widespread information campaigns about safe pregnancy should be conducted among the population.