{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T05:20:08Z","timestamp":1768108808315,"version":"3.49.0"},"reference-count":36,"publisher":"Wiley","issue":"5-6","license":[{"start":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T00:00:00Z","timestamp":1643587200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Neural tube defects (NTDs) encompass a variety of distinct types. We assessed if the preventive effect of folic acid (FA) varied by NTD type and infant sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined all pregnancies with NTD status confirmation from a pregnancy\u2010monitoring system in selected locations in northern and southern regions of China between 1993 and 1996. Women who took 400\u2009\u03bcg of FA daily during 42\u2009days after last menstrual period were considered FA users. We analyzed NTD prevalence by FA use status, NTD type, geographic region, and infant sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 626,042 pregnancies, 700 were affected by an NTD. Among FA nonusers, 65 pregnancies (8.8 per 10,000) in the north and 51 pregnancies (1.2 per 10,000) in the south were affected by one of the two rare NTDs, that is, craniorachischisis, iniencephaly. FA use prevented occurrence of these two rare NTDs and reduced the prevalence of spina bifida (SB) by 78% (from 17.9 to 3.9 per 10,000) in the north and 51% (from 2.4 to 1.2 per 10,000) in the south. Among FA users, SB prevalence, including SB with high lesion level, was significantly reduced in both geographic regions. FA use reduced prevalence of anencephaly and encephalocele by 85% and 50%, respectively in the north, while it did not reduce the prevalence of these two NTDs in the south. There was a greater reduction in NTD prevalence in female than in male infants and fetuses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This is the first study to show that FA prevents the entire spectrum of NTD types.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.1983","type":"journal-article","created":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T09:49:20Z","timestamp":1643622560000},"page":"184-196","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Periconceptional folic acid use prevents both rare and common neural tube defects in China"],"prefix":"10.1002","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1413-6377","authenticated-orcid":false,"given":"Ying","family":"Zhou","sequence":"first","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6997-5955","authenticated-orcid":false,"given":"Krista S.","family":"Crider","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1553-5935","authenticated-orcid":false,"given":"Lorraine F.","family":"Yeung","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2359-8060","authenticated-orcid":false,"given":"Charles E.","family":"Rose","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhu","family":"Li","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Child Health School of Public Health, Peking University  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7162-5046","authenticated-orcid":false,"given":"Robert J.","family":"Berry","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Song","family":"Li","sequence":"additional","affiliation":[{"name":"Peking University Third Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4224-2692","authenticated-orcid":false,"given":"Cynthia A.","family":"Moore","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,1,31]]},"reference":[{"issue":"2","key":"e_1_2_10_2_1","first-page":"69","article-title":"Prevalence of neural tube defects in northeastern France, 1979\u20101994. Impact of prenatal diagnosis","volume":"40","author":"Alembik Y.","year":"1997","journal-title":"Annales de G\u00e9n\u00e9tique"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199911113412001"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.13548"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20536"},{"issue":"14","key":"e_1_2_10_6_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_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/wdev.71"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.10111"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu3030370"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqy065"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.110.004671"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199212243272602"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20485"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067103"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/tera.1420440508"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1221"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/133.11.3630"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.23.2981"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.23036"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/tera.1420500503"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/cga.12333"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3016.2003.00478.x"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12937-018-0421-3"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-022565"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/0887-8994(94)90345-X"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1589"},{"key":"e_1_2_10_27_1","first-page":"66","volume-title":"Neural tube defects. From origin to treatment","author":"Moore C. A.","year":"2006"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8628(19971212)73:2<113::AID-AJMG2>3.0.CO;2-V"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)90133-A"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0193127"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.96.5.880"},{"key":"e_1_2_10_32_1","unstructured":"U.S. Department of Human and Health Services(2018). The HHS regulations for the protection of human subjects in research. 45 C.F.R. part 46.102(l)(2)."},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a008953"},{"issue":"1","key":"e_1_2_10_34_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":"Morbidity and Mortality Weekly Report"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0041689"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0151586"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0059570"}],"container-title":["Birth Defects Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdr2.1983","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/bdr2.1983","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdr2.1983","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T19:21:52Z","timestamp":1692991312000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/bdr2.1983"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,31]]},"references-count":36,"journal-issue":{"issue":"5-6","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1002\/bdr2.1983"],"URL":"https:\/\/doi.org\/10.1002\/bdr2.1983","archive":["Portico"],"relation":{},"ISSN":["2472-1727","2472-1727"],"issn-type":[{"value":"2472-1727","type":"print"},{"value":"2472-1727","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,31]]},"assertion":[{"value":"2021-12-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}