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Fol8.0

Folsäure – Forschung

Überwiegend Mechanismus / Beobachtung

4 begutachtete Studien

Was die Evidenz sagt

Überwiegend Mechanismus / Beobachtung

Die meisten Studien zu Folsäure sind mechanistisch oder beobachtend statt RCTs, die einen klinischen Effekt messen — betrachte die Ergebnisse als vorläufig.

Die meiste Evidenz stammt aus hochwertigen Meta-Analysen und randomisierten Studien, veröffentlicht 1991–2015.

Basierend auf 4 Studien · 1 Meta-Analyse · 3 RCTs

Konfidenz

Mittlere Konfidenz

Nach Outcome

Women's healthDeutlich geringeres Risiko eines Neuralrohrdefekts bei Beginn vor der Konzeption · Muss mindestens 1 Monat vor der Konzeption etabliert sein und über die ersten 2-3 Monate der Schwangerschaft fortgeführt werden (USPSTF, NCBI Bookshelf NBK593617)
Zu wenige bewertete Studien2 Studien

Ältere Forschungsbasis

Neueste Studie von 2015 · Neueste Meta-Analyse: 2015

199120032015

1RCTCited 2,351×1992

Einfach gesagt: The USPSTF evidence review identifies this Hungarian trial as the only eligible randomised trial of FIRST-occurrence prevention and reports an odds ratio for neural tube defects of 0.131 (95% CI 0.026 to 0.648, p=0.013).

Czeizel AE, Dudás I · N Engl J Med (1992)

Randomised trial of periconceptional vitamin supplementation for prevention of a FIRST neural tube defect (PubMed publication types: Randomized Controlled Trial, Clinical Trial)
Odds ratio for neural tube defects 0.131 (95% CI 0.026 to 0.648), p=0.013, as reported by the USPSTF evidence review 'Folic Acid Supplementation to Prevent Neural Tube Defects' (NCBI Bookshelf NBK593617)
The intervention was a multivitamin containing folic acid, not folic acid alone, so it supports periconceptional supplementation containing folic acid rather than the isolated compound

Quelle ansehen

2RCTCited 2,101×1991

Einfach gesagt: The pivotal recurrence-prevention trial: a randomised, multicentre study of periconceptional folic acid in women who had already had a neural-tube-defect-affected pregnancy.

MRC Vitamin Study Research Group · Lancet (1991)

Randomised, multicentre trial of periconceptional folic acid for prevention of RECURRENT neural tube defects (PubMed publication types: Randomized Controlled Trial, Multicenter Study, Comparative Study)
Cited here as the pivotal recurrence-prevention trial and the origin of the high-dose regimen
The USPSTF evidence review states that 4 mg folic acid reduces the risk of recurrent neural tube defects by more than 70 percent (NCBI Bookshelf NBK593617); that review does not name the trial, so the figure is NOT attributed to this paper and has not been verified against it

3Meta-AnalyseCited 390×2015

Einfach gesagt: The Cochrane synthesis for this indication (CD007950, third edition), covering both the effects and the safety of periconceptional oral folate supplementation for preventing birth defects.

De-Regil LM, Peña-Rosas JP, Fernández-Gaxiola AC, Rayco-Solon P · Cochrane Database Syst Rev (2015)

Cochrane Database of Systematic Reviews CD007950, third edition (PubMed publication types: Meta-Analysis, Systematic Review)
The top-of-pyramid synthesis for the periconceptional indication, and the reason this entry's evidence score is not lower
Covers safety as well as effect, which is why it is the anchor rather than any single trial

Quelle ansehen Kostenloser Volltext

4RCTCited 696×2007

Einfach gesagt: A phase III randomised trial that tested high-dose folic acid against a non-pregnancy endpoint — colorectal adenoma prevention — and is the trial most often cited when the safety of long-term supplementation above the upper limit is questioned.

Cole BF et al. · JAMA (2007)

Multicentre phase III randomised clinical trial of folic acid for colorectal adenoma prevention (PubMed publication types: Randomized Controlled Trial, Clinical Trial Phase III, Multicenter Study)
Included as the counterweight to the prenatal evidence: it tests folic acid outside the periconceptional indication, at a dose above the tolerable upper intake level
Result not transcribed for this entry — the abstract was not read; this is the entry's most important piece of editorial work

Quelle ansehen

In der Forschungsbibliothek ansehen

Folsäure – Forschung

Überwiegend Mechanismus / Beobachtung

Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation.

Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group.

Effects and safety of periconceptional oral folate supplementation for preventing birth defects.

Folic acid for the prevention of colorectal adenomas: a randomized clinical trial.