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Many are preventable with folic acid, and access to appropriate services for those affected can improve survival and quality of life. We used a compartmental model to estimate global and regional birth prevalence of NTDs (live births, stillbirths, and elective terminations of pregnancy) and subsequent under\u20105 mortality. Data were identified through web\u2010based reviews of birth defect registry databases and systematic literature reviews. Meta\u2010analyses were undertaken where appropriate. For 2015, our model estimated 260,100 (uncertainty interval (UI): 213,800\u2013322,000) NTD\u2010affected birth outcomes worldwide (prevalence 18.6 (15.3\u201323.0)\/10,000 live births). Approximately 50% of cases were elective terminations of pregnancy for fetal anomalies (UI: 59,300 (47,900\u201374,500)) or stillbirths (57,800 (UI: 35,000\u201388,600)). Of NTD\u2010affected live births, 117,900 (\u223c75%) (UI: 105,500\u2013186,600) resulted in under\u20105 deaths. Our systematic review showed a paucity of high\u2010quality data in the regions of the world with the highest burden. Despite knowledge about prevention, NTDs remain highly prevalent worldwide. Lack of surveillance and incomplete ascertainment of affected pregnancies make NTDs invisible to policy makers. Improved surveillance of all adverse outcomes is needed to improve the robustness of total NTD prevalence estimation, evaluate effectiveness of prevention through folic acid fortification, and improve outcomes through care and rehabilitation.<\/jats:p>","DOI":"10.1111\/nyas.13548","type":"journal-article","created":{"date-parts":[[2018,1,24]],"date-time":"2018-01-24T07:33:03Z","timestamp":1516779183000},"page":"31-46","source":"Crossref","is-referenced-by-count":305,"title":["Estimates of global and regional prevalence of neural tube defects for 2015: a systematic analysis"],"prefix":"10.1111","volume":"1414","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1556-3159","authenticated-orcid":false,"given":"Hannah","family":"Blencowe","sequence":"first","affiliation":[{"name":"Centre for Maternal, Adolescent, Reproductive, and Child Health London School of Hygiene and Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijaya","family":"Kancherla","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Emory University Rollins School of Public Health Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sowmiya","family":"Moorthie","sequence":"additional","affiliation":[{"name":"PHG Foundation Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew W.","family":"Darlison","sequence":"additional","affiliation":[{"name":"World Health Organization Collaborating Centre for Community Genetics, UCL Centre for Health Informatics and Multiprofessional Education (CHIME) University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernadette","family":"Modell","sequence":"additional","affiliation":[{"name":"World Health Organization Collaborating Centre for Community Genetics, UCL Centre for Health Informatics and Multiprofessional Education (CHIME) University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,1,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199911113412006"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyq028"},{"key":"e_1_2_8_4_1","first-page":"CD007950","article-title":"Effects and safety of periconceptional oral folate supplementation for preventing birth defects","author":"De\u2010Regil L.M.","year":"2015","journal-title":"Cochrane Database Syst. 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