{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:40:01Z","timestamp":1782175201728,"version":"3.54.5"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T00:00:00Z","timestamp":1561939200000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"National Key Research and Development Program, Ministry of Science and Technology","award":["2016YFC1000500"],"award-info":[{"award-number":["2016YFC1000500"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81373014"],"award-info":[{"award-number":["81373014"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81202265"],"award-info":[{"award-number":["81202265"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"US Centers for Disease Control and Prevention and Peking University","award":["U01 DD000293"],"award-info":[{"award-number":["U01 DD000293"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Folic acid (FA) supplementation prevents neural tube defects, but there are mixed results for its ability to prevent limb reduction defects. We examined whether a preventive effect of FA supplementation exists for congenital limb reduction defects in a large population in China.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data from a large population-based cohort study in China were used to evaluate the effects of FA supplementation on birth defects. All births at 20 complete gestational weeks, including live births, stillbirths and pregnancy terminations, and all structural congenital anomalies, regardless of gestational week, were recorded. A total of 247\u2009831 singleton live births delivered at gestational ages of 20\u201342\u2009weeks to women from northern and southern China with full information on FA intake were included. Limb reduction defects were classified by subtype and maternal FA supplementation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The prevalence of limb reduction defects was 2.7 per 10\u2009000 births among women who took FA compared with 9.7 per 10\u2009000 births among those who did not take FA in northern China; the prevalence was 4.5 and 3.8 per 10\u2009000 births, respectively, in southern China. In both unadjusted and adjusted analyses, the estimated relative risk for upper limb reduction defects [odds ratio (OR) = 0.17, 95% confidence interval (CI): 0.04, 0.63] and total limb reduction defects (OR = 0.24, 95% CI: 0.08, 0.70) in northern China, but not for lower limb reduction defects ,was significantly decreased in association with FA supplementation in northern China. There was no association between FA supplementation and either an increased or decreased risk for limb reduction defects in southern China.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>FA supplementation successfully reduces the prevalence of limb reduction defects in northern China, whose population has low folate concentrations.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ije\/dyz130","type":"journal-article","created":{"date-parts":[[2019,6,8]],"date-time":"2019-06-08T07:09:46Z","timestamp":1559977786000},"page":"2010-2017","source":"Crossref","is-referenced-by-count":19,"title":["Folic acid supplementation and risk for congenital limb reduction defects in China"],"prefix":"10.1093","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5844-8973","authenticated-orcid":false,"given":"Jufen","family":"Liu","sequence":"first","affiliation":[{"name":"Institute of Reproductive and Child Health\/Key Laboratory of Reproductive Health, National Health Commission of the People\u2019s Republic of China"},{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwen","family":"Li","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Child Health\/Key Laboratory of Reproductive Health, National Health Commission of the People\u2019s Republic of China"},{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongwei","family":"Ye","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Child Health\/Key Laboratory of Reproductive Health, National Health Commission of the People\u2019s Republic of China"},{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiguo","family":"Ren","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Child Health\/Key Laboratory of Reproductive Health, National Health Commission of the People\u2019s Republic of China"},{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianmeng","family":"Liu","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Child Health\/Key Laboratory of Reproductive Health, National Health Commission of the People\u2019s Republic of China"},{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, P. R. 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