{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T18:15:58Z","timestamp":1792692958210,"version":"4.5.0"},"reference-count":49,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2013,8,2]],"date-time":"2013-08-02T00:00:00Z","timestamp":1375401600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Congenital heart defects (CHDs) are the most common type of congenital anomaly. The precise etiology is unknown and the development of successful primary prevention strategies is challenging. Folic acid may have a protective role; however published results have been inconsistent. This study examines the impact of mandatory folic acid fortification (FAF) on the prevalence of CHDs.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>CHD cases were ascertained using the Alberta Congenital Anomalies Surveillance System, Pediatric Cardiology Clinics, Pathology, and hospital records. The birth prevalence and odds ratios (OR) of isolated CHD cases (i.e., without noncardiac anomalies) were calculated comparing pre\u2010FAF (1995\u20131997) with post\u2010FAF (1999\u20132002).<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The prevalence of isolated CHD cases remained relatively unchanged when pre\u2010FAF (9.34, 95% confidence interval [CI] 8.79\u20139.92) was compared with post\u2010FAF (9.41, 95% CI, 8.93\u20139.91). Left ventricular outflow tract obstruction (LVOTO) decreased post\u2010FAF (OR, 0.76; 95% CI, 0.61\u20130.94). Coarctation of the aorta contributed to this decline (OR, 0.55; 95% CI, 0.32\u20130.92). Atrial septal defect (ASD) (OR, 1.42; 95% CI, 1.13\u20131.80) and ASD with ventricular septal defect (OR, 1.52; 95% CI, 1.10\u20132.10) increased post\u2010FAF. The remaining types of CHDs were unchanged.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>FAF alone does not have an impact on the prevalence of CHDs as a group and the majority of selected types of CHDs in Alberta. The decrease in LVOTO, particularly coarctation of the aorta, may be due to FAF or other environmental factors. The increase in ASD and ASD with ventricular septal defect may reflect an increase in diagnosis and ascertainment. <jats:italic>Birth Defects Research (Part A) 97:564\u2010570, 2013<\/jats:italic>. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdra.23162","type":"journal-article","created":{"date-parts":[[2013,8,2]],"date-time":"2013-08-02T09:53:56Z","timestamp":1375437236000},"page":"564-570","source":"Crossref","is-referenced-by-count":16,"title":["Folic acid fortification and the birth prevalence of congenital heart defect cases in Alberta, Canada"],"prefix":"10.1002","volume":"97","author":[{"given":"Tanya","family":"Bedard","sequence":"first","affiliation":[{"name":"Alberta Congenital Anomalies Surveillance System Alberta Health and Wellness Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Brian","family":"Lowry","sequence":"additional","affiliation":[{"name":"Alberta Congenital Anomalies Surveillance System Alberta Health and Wellness Calgary Alberta Canada"},{"name":"Departments of Medical Genetics and Pediatrics University of Calgary Calgary Alberta Canada"},{"name":"Alberta Children's Hospital Research Institute, and Alberta Health Services Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Sibbald","sequence":"additional","affiliation":[{"name":"Alberta Congenital Anomalies Surveillance System Alberta Health and Wellness Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce R.","family":"Harder","sequence":"additional","affiliation":[{"name":"Alberta Children's Hospital Research Institute, and Alberta Health Services Calgary Alberta Canada"},{"name":"Division of Pediatric Cardiology Department of Pediatrics University of Calgary Calgary Alberta 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