{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T01:23:03Z","timestamp":1751246583879},"reference-count":26,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2013,9,19]],"date-time":"2013-09-19T00:00:00Z","timestamp":1379548800000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The Japanese government recommended in 2000 that women planning pregnancy should take 400 \u03bcg of folic acid daily to decrease the risk of having an infant with spina bifida. We aimed to identify risk factors for the occurrence of spina bifida and to evaluate how the prevalence rate has altered over the past 3 decades.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Subjects comprised 360 women who gave birth to spina bifida\u2010affected offspring and 2333 women who gave birth to offspring without spina bifida between 2001 and 2012. A self\u2010administered questionnaire was used to collect data, which were analyzed by multiple logistic regression models. The prevalence rate of spina bifida was obtained through data provided by international and domestic organizations.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Four variables were significantly associated with the increased risk of having newborns afflicted with spina bifida: not taking folic acid supplements (odds ratios [OR], 2.50; 95% confidence interval [CI], 1.72\u20133.64), presence of spina bifida patients within third\u2010degree relatives (OR, 4.26; 95% CI, 1.12\u201316.19), taking anti\u2010epileptic drugs without folic acid (OR, 20\u00b720; 95% CI, 2.06\u2013198.17), and low birth weight in the newborns \u2264 2500 g (OR, 4.21; 95% CI, 3.18\u20135.59). The prevalence rate of spina bifida has remained 5 to 6 per 10,000 total births and has not shown any decreasing trend over the past 11 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Four risk factors were identified among Japanese women. Because recommendations and information have not decreased the occurrence of spina bifida, the Japanese government should implement mandatory food fortification. <jats:italic>Birth Defects Research (Part A) 97:610\u2013615, 2013<\/jats:italic>. \u00a9 2013 Wiley Periodicals Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdra.23179","type":"journal-article","created":{"date-parts":[[2015,10,13]],"date-time":"2015-10-13T03:28:53Z","timestamp":1444706933000},"page":"610-615","source":"Crossref","is-referenced-by-count":17,"title":["Risk factors for the occurrence of spina bifida (a case\u2013control study) and the prevalence rate of spina bifida in Japan"],"prefix":"10.1002","volume":"97","author":[{"given":"Atsuo","family":"Kondo","sequence":"first","affiliation":[{"name":"Department of Urology Tsushima Rehabilitation Hospital Tsushima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhito","family":"Morota","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery National Center for Child Health and Development Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Ihara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Tsukuba Tsukuba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Saisu","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery Chiba Children's Hospital Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsumi","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Urology Faculty of Medicine University of Miyazaki Miyazaki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoko","family":"Shimokawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery St Mary's Hospital Kurume Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroya","family":"Fujimaki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Maebashi Japan Red Cross Hospital Maebashi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Kitakyushu Rehabilitation Center for Children with Disabilities Kitakyushu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoichi","family":"Shimosuka","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Komaki Shimin Hospital Komaki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoyuki","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Nutritional Science Aichi Gakuin University Nisshin Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,9,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"crossref","first-page":"S22","DOI":"10.1177\/15648265100311S103","article-title":"Fortification of flour with folic acid","volume":"31","author":"Berry RJ","year":"2010","journal-title":"Food Nutr Bull"},{"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":"10.1056\/NEJM199911113412006"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38336.664352.82"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.44.1.65"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067103"},{"key":"e_1_2_6_8_1","first-page":"911","article-title":"A comparative study of the relative effects of anticonvulsant drugs and dietary folate on the red cell folate status of patients with epilepsy","volume":"65","author":"Goggin T","year":"1987","journal-title":"QJ Med"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/15648265080292S128"},{"key":"e_1_2_6_10_1","volume-title":"The annual report of congenital malformations of 2010","author":"Japan Association of Obstetricians and Gynecologists","year":"2011"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0920-1211(98)00084-9"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1079\/PHN2004630"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741-4520.2009.00232.x"},{"key":"e_1_2_6_14_1","unstructured":"Mass Media Database Service.2013. 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