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تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Examples of clinical guidelines for folic acid supplementation

Examples of clinical guidelines for folic acid supplementation
Indication for supplementation Dose (daily) Start (minimum) Initial duration* Recommended by
High risk
Open NTD any first degree relative of either parent or a personal history of open NTD in either parent[1,2] 4 mg 3 months PTC 12 weeks SOGC, ACOG
Moderate risk
Personal or family history of folate-sensitive congenital anomaly other than NTD[2] 1 mg 3 months PTC 12 weeks SOGC
Family history of NTD (first- or second-degree relative)[2] 1 mg 3 months PTC 12 weeks SOGC
Type I or II diabetes[2-4] 1 mg 3 months PTC 12 weeks SOGC
0.4 mg 1 month PTC 12 weeks ADA, ACOG
Maternal gastrointestinal malabsorption[2] 1 mg 3 months PTC 12 weeks SOGC
Medical conditions associated with risk (advanced liver disease, dialysis, alcohol overuse)[2] 1 mg 3 months PTC 12 weeks SOGC
Low risk
Pregnancy or potential for pregnancy[1,5,6] 0.4 mg At least 1 month PTC 12 weeks ACOG, CDC
0.4 to 0.8 mg 1 month PTC First 2 to 3 months of pregnancy USPSTF
Clinical guidelines vary regarding the dose of folic acid supplementation in females taking antiseizure medications. Refer to UpToDate content on management of epilepsy during preconception, pregnancy, and the postpartum period.

NTD: neural tube defect; PTC: prior to conception; ACOG: American College of Obstetricians and Gynecologists; SOGC: Society of Obstetricians and Gynaecologists of Canada; ADA: American Diabetes Association; USPSTF: United States Preventive Services Task Force; CDC: Centers for Disease Control and Prevention.

* After 12 weeks, supplementation via a routine prenatal vitamin is recommended through the remainder of pregnancy and lactation to fulfill ongoing maternal and fetoplacental folate requirements.
References:
  1. American College of Obstetricians and Gynecologists Committee on Practice Bulletins. Neural tube defects. Number 187. Obstet Gynecol 2017; 130:e279-e290. 2017.
  2. Wilson RD, O'Connor DL. Guideline No. 427: Folic Acid and Multivitamin Supplementation for Prevention of Folic Acid-Sensitive Congenital Anomalies. J Obstet Gynaecol Can 2022; 44:707.
  3. American College of Obstetricians and Gynecologists. Committee on Practice Bulletins-Obstetrics. Number 60: Pregestational diabetes mellitus. Obstet Gynecol 2005;105:675-85. Reaffirmed 2016.
  4. Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes-2018. American Diabetes Association. Diabetes Care. 2018;41(Suppl 1):S137.
  5. US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al. Folic acid for the prevention of neural tube defects: US Preventive Services Task Force recommendation statement. JAMA 2017; 317:183.
  6. Centers for Disease Control and Prevention. Folic Acid recommendations 2018. https://www.cdc.gov/ncbddd/folicacid/recommendations.html (accessed 8/1/2018).
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