{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T15:03:57Z","timestamp":1784300637885,"version":"3.55.0"},"reference-count":50,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Birth defects can cause significant morbidity and mortality. We examined the prevalence of maternal characteristics and risk factors associated with birth defects and examined their associations with prepregnancy multivitamin\/folic acid (MVF) intake and diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from 22 jurisdictions participating in the Pregnancy Risk Assessment Monitoring System (PRAMS) survey (2017\u20132022) of women with recent live births were used. Distributions were calculated for: prepregnancy health factors (MVF intake, diabetes status, obesity, smoking, alcohol use) and for participant characteristics (age, race\/ethnicity, educational attainment, pregnancy intention, federal poverty level). Log\u2010binomial regression was used to calculate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for the associations between selected characteristics and MVF intake and diabetes. Associations between pregnancy intention and MVF intake stratified by selected characteristics were also examined. Finally, differences in longitudinal MVF intake across jurisdictions were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Almost half (48.2%) of women reported no prepregnancy MVF intake; before pregnancy, 52.0% were overweight or had obesity, 57.9% used alcohol, 15.2% smoked, and 3.1% had diabetes. Prepregnancy MVF intake was associated with increased age (\u2265\u200930\u2009years vs. 25\u201329: aPRs\u2009&gt;\u20091.10), higher educational attainment (graduate degree vs. \u2264\u2009high school: aPR\u2009=\u20091.32, 95% CI: 1.17, 1.49), and intended pregnancies (aPR: 1.50, 95% CI: 1.42, 1.58). Diabetes status was not associated with MVF intake or pregnancy intention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prevalence of risk factors for birth defects was high, and differences exist across groups of women. Findings from this study can help inform public health interventions on risk factors that may help improve birth outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bdr2.70057","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T03:33:37Z","timestamp":1778816017000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of Multivitamin\/Folic Acid Intake, Diabetes, and Other Risk Factors for Birth Defects Among Women in the United States, Pregnancy Risk Assessment Monitoring System, 2017\u20132022"],"prefix":"10.1002","volume":"118","author":[{"given":"Eugene C.","family":"Wong","sequence":"first","affiliation":[{"name":"National Center on Birth Defects and Developmental Disorders, Centers for Disease Control and Prevention  Atlanta Georgia USA"},{"name":"G2S Corporation  Shavano Park Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Koh","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disorders, Centers for Disease Control and Prevention  Atlanta Georgia USA"},{"name":"Oak Ridge Institute for Science and Education  Oak Ridge Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine F.","family":"Yeung","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disorders, Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikyong","family":"Shin","sequence":"additional","affiliation":[{"name":"National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan D.","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disorders, Centers for Disease Control and Prevention  Atlanta Georgia USA"},{"name":"Oak Ridge Institute for Science and Education  Oak Ridge Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara T.","family":"Mai","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disorders, Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/003335491312800612"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc26\u2010s015"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/antiox10060871"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009\u20101231"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.12876"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejm199911113412001"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu10010004"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2011.04.009"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7218a1"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.12.018"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu10081114"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010nutr\u2010043020\u2010091647"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejm199212243272602"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/nutrit\/nuv027"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1742\u20104755\u201010\u201050"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995\u2010014\u20101487\u2010y"},{"key":"e_1_2_12_18_1","unstructured":"Driscoll A. andE.Gregory.2020.\u201cIncreases in Prepregnancy Obesity: United States 2016\u20102019.\u201dNCHS Data Brief No. 392. 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