{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:24:12Z","timestamp":1787495052450,"version":"build-2736575974"},"reference-count":5,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,1,25]],"date-time":"2019-01-25T00:00:00Z","timestamp":1548374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U01DD001033"],"award-info":[{"award-number":["U01DD001033"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2019,3,15]]},"abstract":"\n Background<\/jats:title>\n A recent study observed women's restricted carbohydrate diet in the year before conception was associated with increased risk of neural tube defect (NTD)\u2010affected pregnancies. That study corresponded to the era of postfortification of folic acid. Because folic acid and carbohydrate measures would derive from similar foods, investigators of that study could not determine whether the increased risk with restricted carbohydrate intake was a consequence of lower folate intake. We extend their novel observation by examining rigorous NTD data prior to folic acid fortification.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Data were derived from a population\u2010based case\u2013control study of fetuses and infants with NTDs among 1989\u20131991 California births. Interviews were conducted with mothers of 449 NTD cases and with mothers of 458 nonmalformed controls. A standard 100\u2010item food frequency questionnaire was used to assess macro\u2010 and micronutrient intakes based on reported intakes 3 months before conception.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Case mothers were twice as likely to have consumed a low carbohydrate (\u22645th percentile intake among controls) diet with a crude odds ratio of 2.0 (95% confidence interval, 1.2\u20133.4). Adjustment for race\/ethnicity, education, alcohol intake, and folic acid use made very little difference on the odds ratio. Adjustment for total energy intake appeared to be the only factor to slightly attenuate the odds ratio.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Our findings indicate that the association between low carbohydrate intake and NTD risk may not be wholly a function of low folic acid in the postfortification era. Such a finding offers new clues to pursue for the seemingly folate\u2010insensitive NTDs that continue to occur.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/bdr2.1466","type":"journal-article","created":{"date-parts":[[2019,1,25]],"date-time":"2019-01-25T06:54:41Z","timestamp":1548399281000},"page":"248-253","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Women's periconceptional lowered carbohydrate intake and NTD\u2010affected pregnancy risk in the era of prefortification with folic acid"],"prefix":"10.1002","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7438-4914","authenticated-orcid":false,"given":"Gary M.","family":"Shaw","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Neonatal and Developmental Medicine Stanford University School of Medicine Stanford California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatal and Developmental Medicine Stanford University School of Medicine Stanford California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a114416"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1198"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh187"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/78.5.972"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199505000-00005"}],"container-title":["Birth Defects Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbdr2.1466","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdr2.1466","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T08:50:49Z","timestamp":1694681449000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/bdr2.1466"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,25]]},"references-count":5,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,3,15]]}},"alternative-id":["10.1002\/bdr2.1466"],"URL":"https:\/\/doi.org\/10.1002\/bdr2.1466","archive":["Portico"],"relation":{},"ISSN":["2472-1727","2472-1727"],"issn-type":[{"value":"2472-1727","type":"print"},{"value":"2472-1727","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,25]]},"assertion":[{"value":"2018-12-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}