Guideline Optimal serum and red blood cell folate concentrations in women of reproductive age for prevention of neural tube defects / World Health Organization Nutrition for Health and Development.

Format:

Book

Author/Creator:

World Health Organization. Nutrition for Health and Development, author, issuing body.

Language:

English

Subjects (All):

Folic acid in human nutrition.

Physical Description:

1 online resource (viii, 38 pages)

Place of Publication:

Geneva, Switzerland : World Health Organization, 2015.

Summary:

This guideline provides global, evidence-informed recommendations on blood folate concentrations in women of reproductive age for the prevention of neural tube defects in populations. It aims to help Member States and their partners in their efforts to make informed decisions on the appropriate nutrition actions to take to achieve the Millennium Development Goals (MDGs), in particular reduction of child mortality (MDG 4) and improvement of maternal health (MDG 5), through the establishment of appropriate threshold values for red blood cell folate concentrations at the population level. These values may be used to determine the need for, and guide monitoring and evaluation of the impact of, nutrition interventions aimed at improving folate status and preventing congenital anomalies. In order to establish the utility of serum and red blood cell folate as biomarkers of the risk of having a pregnancy affected by neural tube defects, at population level, this guideline examined 4 critical questions: 1. In the absence of an intervention, what are the key genetic, biological and sociodemographic determinants of folate status (serum, plasma or red blood cell folate) in women of reproductive age? 2. What is the threshold concentration of blood folate associated with the lowest probability/risk (depending on the statistical method) of having a pregnancy affected by neural tube defects? 3. Do blood folate concentrations respond to interventions to improve folate status in women? 4. Does the performance of the laboratory assays used to measure folate concentrations affect serum and red blood cell folate readings?This document presents the key recommendations and a summary of the supporting evidence.

Contents:

Acknowledgements

Executive summary

Scope and purpose

Background

Determinants of folate status

Thresholds for folate status in populations

Measurement of folate status

Summary of evidence

Genetic, biological and sociodemographic determinants of folate status (serum, plasma or red blood cell folate) in women of reproductive age

Blood folate concentrations and risk of neural tube defects

Response of serum/plasma and red blood cell folate concentrations to nutrition interventions

Performance of laboratory assays for assessment of folate concentrations

Recommendations

Remarks

Implications for future research

Dissemination, adaptation and implementation

Dissemination

Adaptation and implementation

Monitoring and evaluation of guideline implementation

A harmonization programme for folate microbiological assays

Ethical considerations

Guideline development process

Advisory groups

Scope of the guideline and evidence appraisal

Management of competing interests

Plans for updating the guideline

References

Annex 1 GRADE "Summary of findings" table

Annex 2 Summary of guideline development group members' considerations for determining the strength of the recommendations

Annex 3 WHO steering committee, WHO guideline development group, WHO Secretariat and external resource experts

Annex 4 Content expert peer-reviewers

Annex 5 External reviewers (from call for public comments).

Notes:

Description based on publisher supplied metadata and other sources.