{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T16:59:29Z","timestamp":1761929969931,"version":"3.40.5"},"reference-count":62,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,12,18]],"date-time":"2018-12-18T00:00:00Z","timestamp":1545091200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Surveillance Branch of Alberta Health and Wellness"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Despite a substantial prevention of neural tube defects with mandatory folic acid (FA) fortification, a significant number of cases still exist in Alberta, Canada, particularly spina bifida (SB). The purpose of this study was to review cases with SB to provide a possible explanation as to why SB is still prevalent in Alberta.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cases with SB born between 2001 and 2015, ascertained by the Alberta Congenital Anomalies Surveillance System, were reviewed. Cases were classified as lipomeningomyelocele, syndrome\/recognized condition, chromosome, associated multiple congenital anomalies, and isolated. The notice of birth forms were reviewed to determine FA supplement use before and\/or during pregnancy. Socioeconomic status (SES) was also examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The majority of cases were isolated (58%). The total prevalence of SB for 2001\u20132015 was 0.37\/1,000 births, with isolated SB being 0.21\/1,000 births. Urinary and congenital heart defects were the most frequently identified associated anomalies. FA supplementation could not be determined for 69% of our cases because of a lack of completeness of the notice of birth forms. There was no significant difference regarding SES between mothers of cases and all mothers in Alberta.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>It is important to examine cases with isolated SB to determine why mandatory FA fortification has not completely prevented SB and to identify which cases are not folate\u2010responsive. A more concerted effort of public health education and promotion with the identification of women with suboptimal folate status and a better understanding of the role of other micronutrients is necessary.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.1438","type":"journal-article","created":{"date-parts":[[2018,12,18]],"date-time":"2018-12-18T15:37:16Z","timestamp":1545147436000},"page":"151-158","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Prevalence rates of spina bifida in Alberta, Canada: 2001\u20132015. Can we achieve more prevention?"],"prefix":"10.1002","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8568-7598","authenticated-orcid":false,"given":"R. Brian","family":"Lowry","sequence":"first","affiliation":[{"name":"Alberta Congenital Anomalies Surveillance System, Clinical Genetics, Alberta Health Services  Calgary Alberta Canada"},{"name":"Departments of Pediatrics and Medical Genetics University of Calgary and Alberta Children's Hospital  Calgary Alberta Canada"},{"name":"Alberta Children's Hospital Research Institute  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanya","family":"Bedard","sequence":"additional","affiliation":[{"name":"Alberta Congenital Anomalies Surveillance System, Clinical Genetics, Alberta Health Services  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda J.","family":"MacFarlane","sequence":"additional","affiliation":[{"name":"Nutrition Research Division, Health Canada  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Crawford","sequence":"additional","affiliation":[{"name":"Alberta Perinatal Health Program, Alberta Health Services  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Sibbald","sequence":"additional","affiliation":[{"name":"Alberta Congenital Anomalies Surveillance System, Clinical Genetics, Alberta Health Services  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B. Calypse","family":"Agborsangaya","sequence":"additional","affiliation":[{"name":"Analytics and Reporting Branch, Alberta Health  Edmonton Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,12,18]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Alberta Health Analytics and Performance Reporting. Alberta Congenital Anomalies surveillance system: Eleventh report 1997\u20132014. Edmonton: Government of Alberta 2017.https:\/\/open.alberta.ca\/dataset\/f8b42b59\u2010ffc6\u20104b34\u20109156\u201027d832bb781c\/resource\/8bc10915\u20102fa5\u20104ccd\u20108522\u2010a70a132f3feb\/download\/congenital\u2010anomalies\u2010report\u201011\u20102017.pdf"},{"key":"e_1_2_8_3_1","unstructured":"Alberta Health and Wellness. Alberta Congenital Anomalies Surveillance System Fifth Report 1980\u20131998. 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