1 Apple

1/2 Beet

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4-6 Carrots

6 Strawberries

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1 Apple

1 Handful of Grapes

1 Orange

1/4 Pineapple

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2 Apples

2 Kiwis

2 Pears

1 Stick of Celery

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Great Folic Acid Article

Neural Tube Defect Surveillance and Folic Acid Intervention — Texas-Mexico Border, 1993-1998 Morbidity and Mortality Weekly Report, Jan 14, 2000 Neural tube defects (NTDs) are common and serious malformations that originate early in pregnancy. In the United States, approximately 4000 pregnancies each year are affected by the two most common NTDs (spina bifida and anencephaly). In 1992, the Texas Department of Health (TDH), with support from a CDC cooperative agreement, implemented the Texas Neural Tube Defect Project (TNTDP), a program of NTD surveillance and risk-reduction activities in the 14 counties that border Mexico. The project was initiated in response to an anencephaly cluster identified during 1990--1991 in Brownsville (Cameron County), Texas [1]. Whether the high anencephaly rate (19.7 per 10,000 live births) was unique to Cameron County or was characteristic of the entire border was unknown. This report summarizes NTD surveillance rates for the 14 Texas-Mexico border counties for 1993--1998 and presents preliminary results of TNTDP efforts to prevent the recurrence of NTDs by providing folic acid to high-risk women. Findings indicate that the baseline rate along the border is high (13.4 per 10,000 live births) and largely reflects the rate among Hispanics (13.8). Although a longer period is needed to obtain definitive results, folic acid appears to be effective for reducing the risk for NTD recurrence in Hispanics. The TNTDP surveillance system involved prospective case finding (International Classification of Diseases, Ninth Revision [ICD-9], codes 740, 741, and 742.0, for all gestational ages) using the following data sources: hospitals; birthing centers; ultrasound centers; abortion centers; prenatal clinics; genetics clinics; and birth attendants including lay midwives, certified nurse midwives, and nonhospital physicians. Data on NTD cases were collected by three field teams (El Paso, Harlingen, and Laredo), abstracted onto standardized forms, and sent to TDH with confirmatory medical records. Denominator data (live birth, death, and fetal death records) were derived from the Bureau of Vital Statistics at TDH; 91% of the resident live births in the border counties were to Hispanic women of Mexican ancestry. For 1993--1998, NTD surveillance rates include cases at all gestational ages for the 14 Texas-Mexico border counties (Table 1). The surveillance system identified 360 resident NTD-affected births/terminations (cases) not otherwise accompanied by a known trisomy, triploidy, or syndrome (e.g., Turner, Meckel, or amniotic band). Of these cases, 324 (90%) occurred in the four most populous border counties--Cameron, El Paso, Hidalgo, and Webb. The overall NTD rate in the border counties for 1993-1998 was 13.4 per 10,000 live births (6.1 for anencephaly, 6.3 for spina bifida, and 1.0 for encephalocele) (Table 1). The craniorachischisis (contiguous opening of brain and spinal column; included in anencephaly) rate in the border counties was 0.5. For the rest of the article, click here.