{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:06:10Z","timestamp":1791230770084,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2008,12,9]],"date-time":"2008-12-09T00:00:00Z","timestamp":1228780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2009,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>BACKGROUND:<\/jats:bold> The number of countries fortifying wheat and maize flour with folic acid has increased in the past 2 years. Folic acid prevents most cases of spina bifida and anencephaly by raising serum folate levels among women capable of bearing children, as does encouraging women to consume folic acid supplements prior to pregnancy. <jats:bold>METHODS:<\/jats:bold> The progress in preventing these serious birth defects can be measured by tracking the number of countries now fortifying and program coverage in each. Country estimates of the number of pregnancies affected by spina bifida and anencephaly are calculated using a prefortification birth prevalence baseline and estimates of the proportion prevented by wheat and maize flour fortified with folic acid. <jats:bold>RESULTS:<\/jats:bold> Current fortification programs are preventing about 22,000, or 9% of the estimated folic acid\u2010preventable spina bifida and anencephaly cases. This represents an annual global decrease of about 6,600 folic acid\u2010preventable spina bifida and anencephaly cases since 2006. <jats:bold>CONCLUSIONS:<\/jats:bold> The pace of preventing these serious birth defects can be accelerated if more countries require fortification of both wheat and maize flour and if regulators set fortification levels high enough to increase a woman's daily average consumption of folic acid to 400 mcg. Birth Defects Research (Part A), 2009. \u00a9 2008 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/bdra.20504","type":"journal-article","created":{"date-parts":[[2008,12,10]],"date-time":"2008-12-10T00:06:30Z","timestamp":1228867590000},"page":"102-107","source":"Crossref","is-referenced-by-count":61,"title":["Update on prevention of folic acid\u2010preventable spina bifida and anencephaly"],"prefix":"10.1002","volume":"85","author":[{"given":"Karen N.","family":"Bell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Godfrey P.","family":"Oakley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2008,12,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20304"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199911113412001"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20307"},{"key":"e_1_2_6_5_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":"Centers for Disease Control and Prevention","year":"1992","journal-title":"MMWR"},{"key":"e_1_2_6_6_1","unstructured":"ChristiansonA ModellB.2006.March of Dimes Global Report on Birth Defects: The Hidden Toll of Dying and Disabled Children. 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