Birth defects are one of the most significant causes of infant mortality affecting approximately 1-3% of all births worldwide, of which the etiology remains widely unclear. One exception to the list, with a strongly supported ethology is the neural tube defect (NTD): affecting more than 300,000 pregnancies every year worldwide . Neural tube defects are classified into three groups: spina bifida, encephalocele and anencephaly, with fatality rates of 7%, 46% and 100%
(incompatible with life) respectively . Spina bifida, affecting the development of spinal cord structures, is presented with the failure of fusion of the spinal column leading to a herniation (as in spina bifida occulta), an exposure of the meninges and cerebrospinal fluid (meningocele) or an exposure of spinal cord (myelomeningocele). With its lowest fatality and therefore highest likeliness of survival rate among the neural tube defects, spina bifida is associated with
significant lifelong morbidities and debilitating disabilities such as urinary and fecal incontinence and paralysis of the lower limbs.
Folic acid deficiency is often found in women with insufficient intake of fresh green leafy vegetables, legumes and animal protein. The role of folate deficiency in the etiology of NTDs has been thoroughly studied over the past decades. Though the exact mechanism remains unclear, studies strongly suggest that folic acid supplementation at the initial phase of conception and in the first 12 weeks of pregnancy is associated with significant reduction of neural tube defect incidence by approximately 70%.
(www.cdc.gov/mmwr/preview/mmwrhtml/mm6401a2.htm , www.ncbi.nlm.nih.gov/pmc/articles/PMC3257747/)
● To reduce the rate of preventable birth defects within DPRK by providing daily fortified bread to mothers with intent to conceive.
● To improve awareness of role of micronutrients and congenital malformations in the maternal and healthcare communities.
● To identify and maintain regular and consistent contact with mothers with intent to conceive.
● Introduce evidence-based practices for reduction of birth defects.
● Contribute to the overall health of mothers and newborns