{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T22:15:54Z","timestamp":1762640154411,"version":"3.41.2"},"reference-count":50,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T00:00:00Z","timestamp":1711324800000},"content-version":"vor","delay-in-days":24,"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":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Maternal folate and vitamin B<jats:sub>12<\/jats:sub> deficiency can lead to serious adverse pregnancy outcomes. There are no nationally representative estimates on folate and vitamin B<jats:sub>12<\/jats:sub> status among women of reproductive age (WRA) in Malawi.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We assessed folate and vitamin B<jats:sub>12<\/jats:sub> status among nonpregnant WRA in Malawi and predicted the risk of folate\u2010sensitive neural tube defects (NTDs) were they to become pregnant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using data from the cross\u2010sectional, nationally representative 2015\u20132016 Malawi Micronutrient Survey, we calculated the proportion of folate and vitamin B<jats:sub>12<\/jats:sub> deficiency and insufficiency by demographic characteristics among 778 nonpregnant WRA (15\u201349\u2009years). We predicted NTD prevalence using red blood cell (RBC) folate distributions and a published Bayesian model of the association between RBC folate and NTD risk. Analyses accounted for complex survey design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among WRA, 8.5% (95% CI: 6.2, 11.6) and 13.3% (10.0, 17.4) had serum (&lt;7\u2009nmol\/L) and RBC folate (&lt;305\u2009nmol\/L) deficiency, respectively. The proportion of vitamin B<jats:sub>12<\/jats:sub> deficiency (&lt;148\u2009pmol\/L) and insufficiency (\u2264221\u2009pmol\/L) was 11.8% (8.6, 16.0) and 40.6% (34.1, 47.4), respectively. RBC folate insufficiency (&lt;748\u2009nmol\/L, defined as the concentration associated with the threshold for elevated NTD risk: &gt;8 cases per 10,000 births) was widespread: 81.4% (75.0, 86.4). The predicted NTD risk nationally was 24.7 cases per 10,000 live births. RBC folate insufficiency and higher predicted NTD risk were more common among WRA living in urban areas or with higher education.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings highlight the importance of nutritional and NTD surveillance in Malawi and the opportunity for improving folate and vitamin B<jats:sub>12<\/jats:sub> nutrition among Malawian WRA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.2329","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T13:34:52Z","timestamp":1711373692000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Folate and vitamin <scp>B<sub>12<\/sub><\/scp> status and predicted neural tube defects risk among nonpregnant women of reproductive age from the <scp>Malawi National Micronutrient Survey<\/scp>, 2015\u20132016"],"prefix":"10.1002","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1764-6863","authenticated-orcid":false,"given":"Yan Ping","family":"Qi","sequence":"first","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC)  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 (CDC)  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8453-9112","authenticated-orcid":false,"given":"Anne M.","family":"Williams","sequence":"additional","affiliation":[{"name":"McKing Consulting Corporation  Atlanta Georgia 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