{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T02:52:55Z","timestamp":1767840775612,"version":"3.49.0"},"reference-count":34,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,4,6]],"date-time":"2023-04-06T00:00:00Z","timestamp":1680739200000},"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":[[2023,5,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Congenital anomalies are the fifth most common cause of neonatal mortality in Nicaragua, and neural tube defects (NTDs) are the most common of all cases of lethality associated with a birth defect. Prevalence and mortality estimates are needed to propose effective intervention strategies that prevent NTDs over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional study was carried out in northwestern Nicaragua from January 2006 to December 2018. All cases of NTDs (anencephaly, spina bifida, and encephalocele) were registered in hospital surveillance systems, and the medical histories of the mothers and newborns were reviewed. Prevalence was calculated by considering the number of live births and stillbirths older than 20\u2009weeks of gestation with NTDs, divided by the total number of live births and stillbirths in each study year. Neonatal mortality rate (NMR) for NTD, and case fatality for spina bifida was calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred fifty cases of NTDs were identified from 178,498 deliveries (177,316 live births and 1,182 stillbirths). The prevalence of NTDs during this time period was 14.01 (95% CI: 12.27\u201315.74) per 10,000 births. The prevalence of spina bifida (<jats:italic>n<\/jats:italic>\u2009=\u2009140), anencephaly (<jats:italic>n<\/jats:italic>\u2009=\u200997), and encephalocele (<jats:italic>n<\/jats:italic>\u2009=\u200913) was 7.84, (95% CI: 6.54\u20139.14), 5.43 (95% CI: 4.30\u20136.45), and 0.73 (95% CI: 0.33\u20131.12) per 10,000 births, respectively. Mothers with fetus or newborns affected with NTDs did not use folic acid prior to conception, and 11% experienced periods of hyperthermia during the first trimester of pregnancy. NMR for NTDs was 0.55 per 1.000 livebirths. Case fatality for all NTDs and for spina bifida were 55% and 18%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The prevalence and mortality of NTDs in the northwestern region of Nicaragua present peaks and troughs during the study period. Spina bifida was the most frequent type of NTD. We believe that these findings could be of use by health policy makers to strengthen the primary prevention of NTDs in the region through the monitoring of the food fortification policy and folic acid supplementation to women of childbearing age. Additional etiologic studies of NTDs should be considered to identify additional prevention measures.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.2174","type":"journal-article","created":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T04:03:51Z","timestamp":1680840231000},"page":"945-953","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Neural tube defects: Prevalence, mortality, and maternal characteristics in two departmental hospitals in the northwestern region of Nicaragua, 2006\u20132018"],"prefix":"10.1002","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2731-7089","authenticated-orcid":false,"given":"Dania Mar\u00eda","family":"Pastora Bucardo","sequence":"first","affiliation":[{"name":"Pediatric Department National Autonomous University of Nicaragua, UNAN\u2010Leon  Leon Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fredman","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medical Sciences National Autonomous University of Nicaragua\u2014Le\u00f3n  Le\u00f3n Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7862-0101","authenticated-orcid":false,"given":"Mar\u00eda","family":"Montes Pastora","sequence":"additional","affiliation":[{"name":"Department of Public Health National Autonomous University of Nicaragua  Le\u00f3n Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula Andrea","family":"Pimienta Ramirez","sequence":"additional","affiliation":[{"name":"Center for Precision Environmental Health, Departments of Molecular and Human Genetics, Molecular and Cellular Biology and Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Indiana L\u00f3pez","family":"Bonilla","sequence":"additional","affiliation":[{"name":"Department of Public Health National Autonomous University of Nicaragua  Le\u00f3n Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadja A","family":"Vielot","sequence":"additional","affiliation":[{"name":"Department of Family Medicine University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard H.","family":"Finnell","sequence":"additional","affiliation":[{"name":"Center for Precision Environmental Health, Departments of Molecular and Human Genetics, Molecular and Cellular Biology and Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,6]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Acevedo C. 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(2019).Analisis epidemiologico sobre los defectos congenitos registrados durante 2018 en Costa Rica Reporte anual 2019. (Issue 506)."},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PONE.0206212"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199911113412001"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.13548"},{"key":"e_1_2_10_11_1","unstructured":"Christianson A. Howson C. P. &Modell B.(2005).March of Dimes: Global report on birth defects the hidden toll of dying and disabled children. March of Dimes: Global Report on Birth Defects the Hidden Toll of Dying and Disabled Children."},{"key":"e_1_2_10_12_1","unstructured":"COMIECO. (2010).Publicaci\u00f3n de la Resoluci\u00f3n No 201\u20102007(COMIECOXLV) Reglamento T\u00e9cnico Centroamericano RTCA 67.01.15:07 Harinas Harina de Trigo Fortificada Especificaciones."},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2015.7"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu3030370"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fgene.2021.659612"},{"key":"e_1_2_10_16_1","unstructured":"Guti\u00e9rrez S\u00e1nchez J. D.(2017).Patr\u00f3n alimentario y la percepci\u00f3n de la Seguridad Alimentaria de las familias de la comunidad de Cosig\u00fcina\u2010Chinandega en el periodo pre cosecha de man\u00ed. Octubre 2016\u2013Febrero 2017. Universidad Nacional Aut\u00f3noma de Nicaragua Managua."},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-3806(01)00295-4"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph10094352"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2116032"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.13601"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.ANNEPIDEM.2017.10.010"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.7189\/JOGH.04.010402"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/BDR2.1589"},{"key":"e_1_2_10_24_1","volume-title":"Reporte de la Prevalencia Hospitalaria de Malformaciones Cong\u00e9nitas en Honduras","author":"Milla G.","year":"2002"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/5364827"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ede.0000152903.55579.15"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.47162\/RJME.61.2.03"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(90)90060-I"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/AJMG.C.31872"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/85.1.285S"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnmol.2017.00237"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000659"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1222002"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00010"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0151586"}],"container-title":["Birth Defects Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdr2.2174","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T18:41:26Z","timestamp":1692470486000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/bdr2.2174"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,6]]},"references-count":34,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,5,15]]}},"alternative-id":["10.1002\/bdr2.2174"],"URL":"https:\/\/doi.org\/10.1002\/bdr2.2174","archive":["Portico"],"relation":{},"ISSN":["2472-1727","2472-1727"],"issn-type":[{"value":"2472-1727","type":"print"},{"value":"2472-1727","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,6]]},"assertion":[{"value":"2022-09-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}