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One is that a trophoblastic cell rest, remaining from a previous aborted pregnancy, interferes with normal embryogenesis. The second is that the previous lost fetus was affected with NTD. We studied the obstetric history of mothers of newborn infants with NTDs compared to those with other birth defects, in low and high risk groups for NTD (Jew and Bedouins). A significantly higher spontaneous abortion rate (48%) in the preceding pregnancy was found in the NTD group compared to the group with other birth defects (20%). This was especially remarkable for spina bifida cases in the Jewish study population. A significantly higher rate of preceding spontaneous abortion was also found in congenital heart defects (CHD) when compared to other congenital malformations. A hypothesis based on the multifactorial threshold model is put forward to explain these findings. Based on the realization that spontaneous abortion constitutes a high risk factor for NTD and possibly also CHD, we recommend a delay of subsequent pregnancy and periconceptional treatment with folic acid following spontaneous abortion. \u00a9 1994 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ajmg.1320510203","type":"journal-article","created":{"date-parts":[[2005,6,11]],"date-time":"2005-06-11T17:12:13Z","timestamp":1118509933000},"page":"93-97","source":"Crossref","is-referenced-by-count":27,"title":["Spontaneous abortion\u2013high risk factor for neural tube defects in subsequent pregnancy"],"prefix":"10.1002","volume":"51","author":[{"given":"R.","family":"Carmi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Gohar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Meizner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Katz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,6,7]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0021932000009585"},{"key":"e_1_2_1_3_1","unstructured":"CarmiR LeviA(1986):Controlled study of birth defects in newborns in the Negev area(unpublished data)."},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.10.3.209"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.4.5999.743"},{"key":"e_1_2_1_6_1","first-page":"455","article-title":"Aetiology of anencephaly and spina bifida","volume":"1","author":"Clarke C","year":"1976","journal-title":"Br Med J"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199212243272602"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0004.1980.tb00872.x"},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(76)92997-4"},{"key":"e_1_2_1_10_1","first-page":"73","article-title":"Factors associated with anencephalus and spina bifida in Belfast","volume":"27","author":"Elwood JH","year":"1973","journal-title":"Br J Prev Soc Med"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.6169.975"},{"key":"e_1_2_1_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.4.5895.753"},{"key":"e_1_2_1_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.6027.107-b"},{"key":"e_1_2_1_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.6119.1016"},{"key":"e_1_2_1_15_1","first-page":"213","article-title":"Defects of the central nervous system in Finland II. 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