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Researchers at the MUHC show the effectiveness of folic acid
in preventing congenital heart defects

The Canadian policy of fortifying grain products with folic acid has already proved to be effective in preventing neural tube defects. The latest article published in the British Medical Journal by a group of researchers from the McGill Adult Unit for Congenital Heart Disease (MAUDE Unit), the Research Institute of the McGill University Health Centre (MUHC) and McGill University, shows that folic acid also decreases the incidence of congenital heart defects by more than 6%.

According to Raluca Ionescu-Ittu, a PhD candidate on the team, "this decrease is very significant and probably underestimated. During the study period, there was an increase in other factors associated with a higher prevalence of congenital heart defects, so without the fortification we would probably have seen an increase in these defects."

Since December 1998, all grain products sold in Canada have been fortified with folic acid with 0.15 mg of folate per 100 g of flour. Thanks to provincial databases, the researchers showed that the rate of congenital heart defects between 1999 and 2005 was 1.47 per 1000 births compared to 1.64 per 1000 births between 1990 and 1999 for a decrease of 6.2% per year after 1999.

Despite the success of this initiative, prevention efforts are still necessary to encourage future mothers to take folic acid supplements. "The level of fortification was established to avoid negative side effects in the general population," explained Ms. Ionescu-Ittu. "However, this level is not quite sufficient for women planning a pregnancy, who should start taking folic acid supplements at least three months before becoming pregnant."

Researchers are constantly assessing the beneficial effects of folic acid on the various aspects of embryonic and infant development. Natural sources of the vitamin, such as fruit or green vegetables, might not provide sufficient doses for pregnant women. Most gynecologists therefore recommend supplements in addition to a healthy diet rich in folic acid.

Funding
This study was financially supported by the Fonds de recherche en sant茅 du Qu茅bec and the Heart and Stroke Foundation.

Raluca Ionescu-Ittu
Raluca Ionescu-Ittu is a PhD candidate in the Department of Epidemiology, Biostatistics and Occupational Health at McGill University.


Dr. Louise Pilote is Director of the Division of General Internal Medicine at the MUHC and a Professor of Medicine at McGill University.

Partners
This study was conducted by Raluca Ionescu-Ittu, McGill University; Dr. Ariane J. Marelli, MAUDE Unit. MUHC and McGill University; Dr. Andrew S. Mackie, University of Alberta; and Dr. Louise Pilote, MUHC and McGill University.


The Research Institute of the McGill University Health Centre (RI MUHC) is a world-renowned biomedical and health-care hospital research centre. Located in Montreal, Quebec, the institute is the research arm of the MUHC, the university health center affiliated with the Faculty of Medicine at McGill University. The institute supports over 600 researchers, nearly 1200 graduate and post-doctoral students and operates more than 300 laboratories devoted to a broad spectrum of fundamental and clinical research. The Research Institute operates at the forefront of knowledge, innovation and technology and is inextricably linked to the clinical programs of the MUHC, ensuring that patients benefit directly from the latest research-based knowledge.
The Research Institute of the MUHC is supported in part by the Fonds de la recherche en sant茅 du Qu茅bec.
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isabelle.kling [at] muhc.mcgill.ca