{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:51:24Z","timestamp":1787313084735,"version":"build-2736575974"},"reference-count":54,"publisher":"Wiley","issue":"19","license":[{"start":{"date-parts":[[2019,8,21]],"date-time":"2019-08-21T00:00:00Z","timestamp":1566345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006087","name":"National Center on Birth Defects and Developmental Disabilities","doi-asserted-by":"publisher","award":["U01DD001184"],"award-info":[{"award-number":["U01DD001184"]}],"id":[{"id":"10.13039\/100006087","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K01HL133600"],"award-info":[{"award-number":["K01HL133600"]}],"id":[{"id":"10.13039\/100000050","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":[[2019,11,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Women with a previous neural tube defect (NTD)\u2010affected pregnancy are recommended to consume 4,000\u2009\u03bcg daily folic acid (FA) for prevention (10 times the general\u2010population recommendation). Protection from doses between 400 and 4,000\u2009\u03bcg for this and other higher risk groups is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In the case\u2013control Slone Birth Defects Study (1988\u20132015), we examined the associations between periconceptional FA doses and NTDs among four higher risk groups: NTD family history, periconceptional antiepileptic drug exposure (AED), pregestational diabetes, and prepregnancy obesity. Mothers completed standardized interviews about pregnancy events and exposures. FA categorizations were based on (a) supplements only and (b) supplements and diet (\u201ctotal folate\u201d). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) (adjusted for age and study center) using logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cases and controls included: 45 and 119 with family history, 25 and 108 with AED exposure, 12 and 63 with pregestational diabetes, 111 and 1,243 with obesity. Daily FA supplementation was associated with lower NTD risk compared to no supplementation (adjusted ORs were 0.33 [95% CI 0.13, 0.76] for family history, 0.31 [0.09, 0.95] for AED exposure, 0.25 [0.04, 1.05] for pregestational diabetes, 0.65 [0.40, 1.04] for obesity). Though estimates were imprecise, as total folate increased stronger point estimates were observed, notably among family history. No mothers with a prior NTD\u2010affected pregnancy supplemented with 4,000\u2009\u03bcg.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings reinforce that all women of childbearing potential should consume at least 400\u2009\u03bcg FA\/day to protect against NTDs. Higher risk groups may benefit from higher doses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bdr2.1579","type":"journal-article","created":{"date-parts":[[2019,8,21]],"date-time":"2019-08-21T05:48:51Z","timestamp":1566366531000},"page":"1501-1512","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Periconceptional folic acid and risk for neural tube defects among higher risk pregnancies"],"prefix":"10.1002","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7845-4545","authenticated-orcid":false,"given":"Julie M.","family":"Petersen","sequence":"first","affiliation":[{"name":"Department of Epidemiology Boston University School of Public Health  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7193-077X","authenticated-orcid":false,"given":"Samantha E.","family":"Parker","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Boston University School of Public Health  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0218-5048","authenticated-orcid":false,"given":"Corey M.","family":"Benedum","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Boston University School of Public Health  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0950-6799","authenticated-orcid":false,"given":"Allen A.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Boston University School of Public Health  Boston Massachusetts"},{"name":"Slone Epidemiology Center Boston University  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7610-6288","authenticated-orcid":false,"given":"Sarah C.","family":"Tinker","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention National Center on Birth Defects and Developmental Disabilities  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3392-6814","authenticated-orcid":false,"given":"Martha M.","family":"Werler","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Boston University School of Public Health  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/GIM.0b013e31821d4188"},{"issue":"3","key":"e_1_2_8_3_1","first-page":"675","article-title":"Practice Bulletin. Clinical Management Guidelines for Obstetrician\u2010Gynecologists. Number 60, March 2005. Pregestational diabetes mellitus. American College of Obstetricians and Gynecologists (ACOG)","volume":"105","author":"ACOG","year":"2005","journal-title":"Obstetrics and Gynecology"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.23100"},{"issue":"1","key":"e_1_2_8_5_1","first-page":"6","article-title":"Supplement use and other characteristics among pregnant women with a previous pregnancy affected by a neural tube defect\u2014United States, 1997\u20132009","volume":"64","author":"Arth A.","year":"2015","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0131130"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199911113412001"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.19438"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-016-2155-1"},{"issue":"30","key":"e_1_2_8_10_1","first-page":"513","article-title":"Use of folic acid for prevention of spina bifida and other neural tube defects\u20141983\u20131991","volume":"40","author":"CDC","year":"1991","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"issue":"14","key":"e_1_2_8_11_1","first-page":"1","article-title":"Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects","volume":"41","author":"CDC","year":"1992","journal-title":"MMWR Recommendations and Reports"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.12.018"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.1320050314"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.21.6.413"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000330776"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm665152a3"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.3171\/2016.12.PEDS1668"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/80.1.27"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980015000555"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-neuro-062012-170354"},{"key":"e_1_2_8_21_1","unstructured":"Harvard. (2018). Semi\u2010quantitative food frequency questionnaire nutrient tables. Retrieved on February 4 2018 from Harvard TH Chan School of Public Healthhttps:\/\/regepi.bwh.harvard.edu\/health\/nutrition.html."},{"key":"e_1_2_8_22_1","volume-title":"Dietary Reference Intakes (DRIs): Recommended dietary allowances and adequate intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline","author":"IOM","year":"1998"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1975"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajpa.1330620106"},{"issue":"1","key":"e_1_2_8_25_1","first-page":"S168","article-title":"The Slone Drug Dictionary: A research driven pharmacoepidemiology tool","volume":"12","author":"Kelley K. E.","year":"2003","journal-title":"Pharmacoepidemiology and Drug Safety"},{"issue":"4","key":"e_1_2_8_26_1","first-page":"394","article-title":"Identifying women who might benefit from higher doses of folic acid in pregnancy","volume":"58","author":"Kennedy D.","year":"2012","journal-title":"Canadian Family Physician"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01552.x"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2042.2008.02163.x"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-387-87959-8"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-014-1609-6"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.19890"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12543"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1535-7597.2002.00017.x"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)90133-A"},{"key":"e_1_2_8_35_1","unstructured":"NHLBI. (1998). Classification of overweight and obesity by BMI waist circumference and associated disease risks. National Heart Lung and Blood Institute (NHLBI). Retrieved fromhttps:\/\/www.nhlbi.nih.gov\/health\/educational\/lose_wt\/BMI\/bmi_dis.htm."},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1975.tb03523.x"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1520-6661(199701\/02)6:1<53::AID-MFM11>3.0.CO;2-N"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20735"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.36324"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.05.047"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.5888\/pcd14.170066"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.20.7.1183"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2017.04.002"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.18.4.245"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/OGX.0b013e318223614c"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.1320150409"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)07104-5"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1993.tb26129.x"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03500100055027"},{"key":"e_1_2_8_50_1","volume-title":"Issues in Analysis and Presentation of Dietary Data Nutritional Epidemiology","author":"Willett W.","year":"2013"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a114366"},{"issue":"1","key":"e_1_2_8_52_1","first-page":"1","article-title":"Updated estimates of neural tube defects prevented by mandatory folic acid fortification\u2014United States, 1995\u20132011","volume":"64","author":"Williams J.","year":"2015","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(15)30230-9"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwx328"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.51.4.949"}],"container-title":["Birth Defects Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbdr2.1579","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdr2.1579","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/bdr2.1579","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdr2.1579","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T08:57:40Z","timestamp":1694163460000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/bdr2.1579"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,21]]},"references-count":54,"journal-issue":{"issue":"19","published-print":{"date-parts":[[2019,11,15]]}},"alternative-id":["10.1002\/bdr2.1579"],"URL":"https:\/\/doi.org\/10.1002\/bdr2.1579","archive":["Portico"],"relation":{},"ISSN":["2472-1727","2472-1727"],"issn-type":[{"value":"2472-1727","type":"print"},{"value":"2472-1727","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,21]]},"assertion":[{"value":"2019-05-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}