Perikonzeptionelle Multivitamingaben führen zur Reduktion angeborener Fehlbildungen: Ausreichende Evidenz zur Formulierung nationaler Empfehlungen für Deutschland?

In the discussion about primary prevention of congenital abnormalities, vitamins often have been picked out as a central theme in literature. In randomised controlled trials, a significant reduction of congenital abnormalities up to 17% by the periconceptional use of multivitamins (folic acid, vitamin B₁₂, vitamin B₆, vitamin C and zinc) were found. This protective effect can be explained by lower prevalence of neural tube defects, cardiovascular malformations, malformations of the urinary system, limb deficiencies and hypertrophic pyloric stenosis. Multivitamin con sumption including 0.8 mg folic acid for at least 28 days before conception and continuing for at least until the second missed menstrual period, have been most effective. These findings in primary prevention of congenital abnormalities raise an import public health issue. Therefore, for women of childbearing age, there are three possibilities of primary prevention of congenital abnormalities: 1. consumption of a vitamin-rich diet, 2. supplementation of vitamins, and 3. food fortification with vitamins. With regard to an appropriate consumption of multivitamins in practice, there are many problems. To ensure that in Germany all women of childbearing age will benefit from the discussions and findings of other countries, food fortification with folic acid and other vitamins should be checked. Furthermore, implementation of a national health policy for Germany should be considered.