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Article
May 23, 1990

Vitamins During Pregnancy and Neural Tube Defects

Author Affiliations

Guy's Hospital London, England
Belfast City Hospital Belfast, Northern Ireland

Guy's Hospital London, England
Belfast City Hospital Belfast, Northern Ireland

JAMA. 1990;263(20):2749. doi:10.1001/jama.1990.03440200049016
Abstract

Tb the Editor.—  We were interested to read the article by Milunsky et al,1 which demonstrated that multivitamins with folic acid, taken in the first 6 weeks of pregnancy, are associated with a significant reduction in the birth prevalence of neural tube defects (NTDs). We congratulate the authors on a fine piece of work.This prospective population occurrence study complements well the intervention study by ourselves and our colleagues,2 which has consistently shown a reduced recurrence of NTDs in at-risk women specifically given multivitamins and folic acid supplementation in the periconceptional period. Milunsky et al note that their results differ from a retrospective case-control study by Mills et al,2 which showed no positive effect on NTDs of periconceptional multivitamins, and they suggest two reasons. We wish to propose a third, the evidence for which we find apparent in our study.The effects of vitamin therapy are more

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