20.500.12556/RUL-184569 Vloga dodajanja folne kisline pri preprečevanju napak nevralne cevi: pregled literature in ekonomska analiza diplomsko delo The role of folic acid supplementation in the prevention of neural tube defects: literature review and economic analysis diploma work Uvod: Folna kislina je v perikoncepcijskem obdobju najbolje preučen preventivni ukrep za preprečevanje napak zapiranja nevralne cevi. Ker se nevralna cev zapre že v prvih 28 dneh po oploditvi, pogosto preden ženska sploh izve, da je noseča, je za preventivo nujno pravočasno dodajanje. V Sloveniji se ženskam, ki načrtujejo nosečnost, priporoča dnevni vnos 400 μg folne kisline najmanj tri mesece pred zanositvijo in v prvih treh mesecih nosečnosti. Namen: Cilj diplomskega dela je ovrednotiti ekonomsko upravičenost individualnega dodajanja folne kisline ženskam, ki načrtujejo nosečnost, kot preventivne strategije za zmanjšanje pojavnosti napak nevralne cevi v Sloveniji. Metode dela: Delo temelji na pregledu strokovne literature, ekonomsko upravičenost dodajanja folne kisline pa smo ovrednotili z analizo učinkovitosti glede na stroške in analizo koristnosti glede na stroške. Rezultati: Rezultati analize kažejo, da je strošek preprečitve posameznega primera napak nevralne cevi v vseh obravnavanih scenarijih nižji od doživljenjskega stroška zdravljenja spine bifide. Ob optimalnem in pravočasnem vnosu folne kisline bi v Sloveniji teoretično preprečili velik del letno pričakovanih primerov napak nevralne cevi. Razprava in zaključek: Individualno dodajanje folne kisline v perikoncepcijskem obdobju se izkaže za stroškovno upravičeno preventivno strategijo, ki ostane veljavna tudi pri konzervativnih predpostavkah; dejanska korist intervencije je najverjetneje višja od izračunane. Ker takšen pristop najtežje doseže prav skupine z nižjo komplianco, je smiselno odpreti tudi vprašanje o obogatitvi živil. Vzpostavitev nacionalnega registra prirojenih napak in usmerjeno ozaveščanje ranljivih skupin bi prispevala k učinkovitejši preventivi v Sloveniji. Introduction: Folic acid is the most thoroughly studied preventive measure during the periconceptional period for the prevention of neural tube defects. Because the neural tube closes within the first 28 days after conception, often before a woman is aware that she is pregnant, timely supplementation is essential for effective prevention. In Slovenia, women planning a pregnancy are advised to take a daily dose of 400 μg of folic acid for at least three months prior to conception and during the first three months of pregnancy. Purpose: The purpose of this thesis is to evaluate the economic justification of individual folic acid supplementation in women planning a pregnancy as a preventive strategy for reducing the incidence of neural tube defects in Slovenia. Methods: The thesis is based on a review of professional literature. The economic justification of folic acid supplementation was evaluated using cost-effectiveness analysis and cost-benefit analysis. Results: The results of the analysis show that the cost of preventing a single neural tube defect case in all examined scenarios is lower than the lifetime cost of treating spina bifida. With optimal and timely intake of folic acid, a large proportion of the annually expected neural tube defects cases in Slovenia could theoretically be prevented. Discussion and conclusion: Individual folic acid supplementation during the periconceptional period proves to be a cost-justified preventive strategy that remains valid even under conservative assumptions; the actual benefit of the intervention is most likely higher than estimated. Since this approach is least likely to reach precisely those groups with lower compliance, the question of food fortification should also be considered. The establishment of a national registry of congenital anomalies, together with targeted awareness-raising among vulnerable groups, would contribute to more effective prevention in Slovenia. diplomska dela babištvo folna kislina prehranska dopolnila napake nevralne cevi spina bifida perikoncepcijsko dodajanje komplianca preventiva diploma theses midwifery folic acid dietary supplements neural tube defects spina bifida periconceptional supplementation compliance prevention true false false [T. Smodiš] Slovenski jezik Angleški jezik Diplomsko delo/naloga 2026-07-10 07:46:16 2026-07-10 07:46:21 2026-07-15 11:01:39 0000-00-00 00:00:00 2026 0 Ljubljana 0 Ljubljana VIII, 25 str. 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 618.2/.7 160416 284878339 59619.pdf 59619.pdf 1 A6B5BFB94E0FE774E7BB9ED3A083410A 8fbffd9844c8e1c67f15bfade9f1134bfb894e9d97c1c19574f0351d2535c85c 8c5ac323-7c22-11f1-9b0d-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=237460 Zdravstvena fakulteta 0 0 0