{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T11:38:15Z","timestamp":1767008295135,"version":"3.40.5"},"reference-count":18,"publisher":"Wiley","issue":"18","license":[{"start":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T00:00:00Z","timestamp":1694736000000},"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":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Fetal deaths are a major source of information on the epidemiology of neural tube defects (NTDs; anencephaly and myelomeningocele). We analyzed NTDs prevalence and secular trend using fetal death records between 1994 and 2019 in Argentina.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Data were obtained from the Department of Statistics and Information of the Ministry of Health (DEIS). Using the number of fetal deaths due to anencephaly and myelomeningocele, we estimated the proportion of all fetal deaths due to anencephaly, myelomeningocele, and NTDs (anencephaly\u2009+\u2009myelomeningocele) during pre\u2010 and post\u2010fortification period in Argentina. We also estimated the ratio of fetal deaths due to anencephaly, myelomeningocele, and NTDs (anencephaly\u2009+\u2009myelomeningocele) to 10,000 live births. Secular trend in the outcomes was analyzed using a Poisson model and Joinpoint regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the entire period analyzed, the NTD proportion on fetal deaths was 1.32. In 1994, NTDs accounted for 34.7% of congenital malformations fetal deaths (CM) and 1.7% of all fetal deaths, whereas in 2019, these percentages were 9.4% and 0.5%, respectively. NTDs present a negative secular trend (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). The risk of fetal death due to anencephaly and myelomeningocele decreases between 2005 and 2019 by 67% and 51% respectively (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) in comparison to the period between 1994 and 2004 before the effective fortification of wheat flour used in the food industry destined for the domestic market.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusion<\/jats:title><jats:p>We found a significant decrease in the risk of all fetal deaths due to NTDs, particularly anencephaly, in Argentina over the study period, with most reduction observed during the mandatory flour fortification era (introduced in Argentina in 2002). The inclusion of fetal deaths in NTD surveillance, coupled or uncoupled with other pregnancy outcomes, is essential for monitoring preventive supplementation measures.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.2248","type":"journal-article","created":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T04:50:14Z","timestamp":1694839814000},"page":"1737-1745","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["\u201cPrevalence and secular trend of neural tube defects in fetal deaths in Argentina, 1994\u20132019\u201d"],"prefix":"10.1002","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8859-3060","authenticated-orcid":false,"given":"Ruben","family":"Bronberg","sequence":"first","affiliation":[{"name":"Medical and Population Genetics Area Ramos Mej\u00eda Hospital  Buenos Aires Argentina"},{"name":"Buenos Aires Government Research Committee  Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Martinez","sequence":"additional","affiliation":[{"name":"Institute of Ecoregions of the Andes National Scientific and Technical Research Council (CONICET)  Jujuy Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonardo","family":"Morales","sequence":"additional","affiliation":[{"name":"Patagonian Institute of Social and Human Sciences (IPCSH CCT CONICET\u2010CENPAT) and Department of Informatics Faculty of Engineering National University of Patagonia San Juan Bosco (UNPSJB)  Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anahi","family":"Ruderman","sequence":"additional","affiliation":[{"name":"Patagonian Institute of Social and Human Sciences (IPCSH CCT CONICET\u2010CENPAT)  Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damian","family":"Taire","sequence":"additional","affiliation":[{"name":"Andr\u00e9s \u00cdsola Zonal Hospital, Puerto Madryn\u2010Patagonian Institute of Social and Human Sciences (IPCSH CCT CONICET\u2010CENPAT)  Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia","family":"Ramallo","sequence":"additional","affiliation":[{"name":"Patagonian Institute of Social and Human Sciences (IPCSH CCT CONICET\u2010CENPAT)  Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Dipierri","sequence":"additional","affiliation":[{"name":"Institute of Ecoregions of the Andes National Scientific and Technical Research Council (CONICET)  Jujuy Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.302902"},{"issue":"6","key":"e_1_2_8_3_1","first-page":"498","article-title":"Prevalence of neural tube defects and estimation of cases averted in the post\u2010fortification period in Argentina","volume":"113","author":"Bidondo M. P.","year":"2015","journal-title":"Archivos Argentinos de Pediatr\u00eda"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyq028"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.13548"},{"issue":"2","key":"e_1_2_8_6_1","first-page":"117","article-title":"Anencephaly related infant mortality in Argentina: Spatial and temporal analysis (1998\u20132007)","volume":"109","author":"Bronberg R.","year":"2011","journal-title":"Archivos Argentinos de Pediatr\u00eda"},{"issue":"6","key":"e_1_2_8_7_1","first-page":"492","article-title":"Impact of folic acid fortification on women's nutritional status and on the prevalence of neural tube defects","volume":"106","author":"Calvo E.","year":"2008","journal-title":"Archivos Argentinos de Pediatr\u00eda"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20485"},{"key":"e_1_2_8_9_1","unstructured":"Directorate of Health Statistics and Information (DEIS. (2019).Registration of causes of death and mortality statistics. Retrieved fromhttp:\/\/www.deis.msal.gov.ar\/wp\u2010content\/uploads\/2019\/09\/resumen\u2010sobre\u2010certificacion\u2010medica\u2010de\u2010causas\u2010de\u2010muerte.pdf"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.04.010402"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.33479"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2004.044305"},{"key":"e_1_2_8_13_1","unstructured":"National network of congenital anomalies of Argentina (RENAC). (2019).Epidemiological analysis on congenital anomalies in newborns registered during 2018. Retrieved fromhttp:\/\/www.anlis.gov.ar\/cenagem\/wp\u2010content\/uploads\/2017\/07\/Reporte\u2010RENAC\u20102019.pdf"},{"key":"e_1_2_8_14_1","first-page":"554","volume-title":"International statistical classification of diseases and related health problems","author":"Pan American Health Organization (PAHO)","year":"2008"},{"key":"e_1_2_8_15_1","unstructured":"RENAC. (2021).An\u00e1lisis epidemiol\u00f3gico sobre las anomal\u00edas cong\u00e9nitas en reci\u00e9n nacidos registradas durante 2020 en la Rep\u00fablica Argentina. Ministerio de Salud.https:\/\/www.ine.gov.ar\/renac\/Rep2021.pdf"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30388-9"},{"issue":"3","key":"e_1_2_8_17_1","first-page":"120","article-title":"Validity of death and stillbirth certificates and hospital discharge summaries for the identification of neural tube defects in Quebec City","volume":"27","author":"Tairou F.","year":"2006","journal-title":"Chronic Diseases in Canada"},{"key":"e_1_2_8_18_1","unstructured":"United nations (UN. (2014).Principles and recommendations for a vital statistics system. Statistical Reports. Serie M No.19\/Rev.3. 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