{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T01:56:36Z","timestamp":1790042196652,"version":"4.0.1"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,2,13]],"date-time":"2013-02-13T00:00:00Z","timestamp":1360713600000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>We investigated the association between maternal obesity (body mass index [BMI] \u2265 30) and the risk of a neural tube defect affected pregnancy (NTD). We also studied relationships between perinatal folate intake from food and the NTD risk by maternal BMI.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Data came from a state\u2010wide case\u2010control study conducted between 1992 and 1997 in South Carolina including 179 women with NTD\u2010affected pregnancies and 288 women without NTD\u2010affected births. A majority of case mothers (77%) and controls (86%) were interviewed within 6 months after delivery or pregnancy termination. Logistic regression models were used to examine the association between maternal obesity and the NTD risk after adjusting for maternal race, age, education, smoking, alcohol\/drug use, chronic conditions, and multivitamin use within six periconceptional months. Stratified analysis by maternal BMI (\u226525 vs. &lt;25) was conducted for the association between food folate and the NTD risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>After adjustment for confounders, obese women (BMI \u2265 30) had twice higher odds of having an NTD\u2010affected pregnancy (odds ratios [OR] = 2.06, 95% confidence interval [CI] = 1.12, 3.81) than normal weight women (BMI: 18.0\u201324.9). Compared to the lowest quartile of average daily folate intake from food, the upper three quartiles had lower odds of NTDs in offspring. The NTD\u2010protective association was stronger in overweight\/obese women (BMI \u2265 25) than in normal\/underweight women (BMI &lt; 25).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>These results support previous studies suggesting maternal obesity as a risk factor for NTDs. Higher intakes of dietary folate were associated with decreased NTD risk that was stronger in overweight and obese women. Birth Defects Research (Part A) 2013. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdra.23113","type":"journal-article","created":{"date-parts":[[2013,2,13]],"date-time":"2013-02-13T06:08:58Z","timestamp":1360735738000},"page":"115-122","source":"Crossref","is-referenced-by-count":47,"title":["Maternal obesity, folate intake, and neural tube defects in offspring"],"prefix":"10.1002","volume":"97","author":[{"given":"Daria M.","family":"McMahon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongmei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myriam E.","family":"Torres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert G.","family":"Best","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,2,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0223(199606)16:6<531::AID-PD914>3.0.CO;2-1"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ede.0000147122.97061.bb"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1989.tb136723.x"},{"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 Recomm Rep"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2010.12.037"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2011.07.013"},{"key":"e_1_2_6_8_1","first-page":"8781","article-title":"Food standards: amendment of standards of identity for enriched grain products to require addition of folic acid, Final Rule. 21 CFR Parts 136, 137, and 139","volume":"61","author":"Food and Drug Administration","year":"1996","journal-title":"Fed Reg"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/hmg\/ddp347"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-200111000-00009"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.23.2981"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009408"},{"key":"e_1_2_6_13_1","volume-title":"Human Embryology","author":"Larsen WJ","year":"1997"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/026010608300200408"},{"key":"e_1_2_6_15_1","first-page":"695","article-title":"Association between maternal obesity and fetal cardiac malformations in African Americans","volume":"94","author":"Mikhail LN","year":"2002","journal-title":"J Natl Med Assoc"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1989.03430200091032"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.EDE.0000040253.12446.B2"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-200011000-00013"},{"key":"e_1_2_6_19_1","unstructured":"National Institutes of Health.2000.The practical guide: identification evaluation and treatment of overweight and obesity in adults. 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