{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T23:12:45Z","timestamp":1756681965947},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2008,11,4]],"date-time":"2008-11-04T00:00:00Z","timestamp":1225756800000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2008,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>BACKGROUND:<\/jats:bold> Prevalences of NTDs are typically 50\u2013100% greater among Hispanic women compared to non\u2010Hispanic Whites. This article examines whether markers of acculturation such as \u201clanguage preference\u201d allow the identification of high\u2010risk groups within the Hispanic population. It also examines whether known NTD risk factors explain observed differences in risk among Hispanic women who are more and less acculturated. <jats:bold>METHODS:<\/jats:bold> This population\u2010based case\u2010control study of deliveries in selected California counties from 1999\u20132003 included 337 NTD cases and 626 nonmalformed, liveborn controls. <jats:bold>RESULTS:<\/jats:bold> Relative to less acculturated US\u2010born Hispanic women (i.e., women who preferred reading and speaking Spanish), other subgroups (i.e., US\u2010born Hispanic women who preferred English, foreign\u2010born Hispanic women regardless of \u201clanguage preference\u201d, and non\u2010Hispanic White women) had approximately twofold increased risks of spina bifida. Only the less acculturated foreign\u2010born women (i.e., women with a preference for Spanish) had substantially increased risk of anencephaly (OR 1.7; 95% CI 0.9, 3.4). Adjustment for several NTD risk factors (maternal intake of folic acid\u2010containing supplements, dietary folate intake, body mass index, food insecurity, stressful life events, smoking, alcohol intake, education, income, and neighborhood education and poverty) resulted in modest or no reductions in most of the ORs. <jats:bold>CONCLUSIONS:<\/jats:bold> The explanation for variability in NTD risks among Hispanic and non\u2010Hispanic White women therefore likely extends beyond most known NTD risk factors. Birth Defects Research (Part A), 2008. \u00a9 2008 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/bdra.20517","type":"journal-article","created":{"date-parts":[[2008,11,4]],"date-time":"2008-11-04T14:15:15Z","timestamp":1225808115000},"page":"755-762","source":"Crossref","is-referenced-by-count":14,"title":["Markers of acculturation and risk of NTDs among Hispanic women in California"],"prefix":"10.1002","volume":"82","author":[{"given":"Suzan L.","family":"Carmichael","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary 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