{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:56:19Z","timestamp":1747187779105,"version":"3.40.5"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T00:00:00Z","timestamp":1622419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2018YFC1004300","2018YFC1004301"],"award-info":[{"award-number":["2018YFC1004300","2018YFC1004301"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Associations between the periconceptional folic acid only (FAO) or multiple micronutrients containing folic acid (MMFA) supplementation and risk for limb defects are inconsistent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the association between periconceptional folic acid supplements use and risk for limb defects, including clubfoot, polydactyly, syndactyly, and limb deficiencies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were derived from a cohort based on a pregnancy registry in a district of Beijing, China, from 2013 to 2018. Information on maternal periconceptional FAO and MMFA supplementation was collected via face\u2010to\u2010face interviews at first trimester. Pregnancy outcomes including limb defects were ascertained in livebirths, stillbirths, and elective pregnancy terminations and were recorded into the system. Propensity score methods were used to adjust for potential confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 63\u00a0969 women with a singleton delivery were included. The overall prevalence of limb defects was 47.5 per 10\u00a0000 (n\u00a0=\u00a063\u00a0969) singleton deliveries. Decreased prevalence of limb defects was found among FAO\/MMFA users compared with women who did not take supplements (nonusers) (46.1 vs. 61.9 per 10\u00a0000 births, adjusted risk ratio [RR] 0.80, 95% confidence interval [CI] 0.56, 1.12). Compared with nonusers (n\u00a0=\u00a06462, 10.2%), women who took either FAO (n\u00a0=\u00a026\u00a0567, 42.0%) or MMFA (n\u00a0=\u00a030\u00a0259, 47.8%) had a lower risk for total clubfoot (RR 0.40, 95% CI 0.20, 0.84), and for isolated clubfoot (RR 0.41, 95% CI 0.17, 0.97). For other limb defects except clubfoot, FAO supplementation did not appear to be associated with reduced risk, while MMFA supplementation group had 30%\u201050% reduced risks for other limb defects. A lower risk for limb defects or isolated limb defects was found with MMFA supplementation when FAO supplementation was used as a control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Maternal periconceptional supplements with either FAO or MMFA had inverse association with clubfoot in offspring, and MMFA was associated with lower risk for isolated limb defects compared with FAO.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12775","type":"journal-article","created":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T09:41:15Z","timestamp":1622540475000},"page":"645-653","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Maternal periconceptional folic acid supplements use and fetus risk for limb defects"],"prefix":"10.1111","volume":"35","author":[{"given":"Jie","family":"Zhang","sequence":"first","affiliation":[{"name":"Institute of Reproductive and Child Health Peking University\/ National Health Commission Key Laboratory Peking University Beijing China"},{"name":"Department of Epidemiology and Biostatistics School of Public Health Peking University Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Jin","sequence":"additional","affiliation":[{"name":"Tongzhou Maternal and Child Health Hospital Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Di","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Child Health Peking University\/ National Health Commission Key Laboratory Peking University Beijing China"},{"name":"Department of Epidemiology and Biostatistics School of Public Health Peking University Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Child Health Peking University\/ National Health Commission Key Laboratory Peking University Beijing China"},{"name":"Department of Epidemiology and Biostatistics School of Public Health Peking University Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6814-0390","authenticated-orcid":false,"given":"Mingkun","family":"Tong","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Child Health Peking University\/ National Health Commission Key Laboratory Peking University Beijing China"},{"name":"Department of Epidemiology and Biostatistics School of Public Health Peking University Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinhui","family":"Yu","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Child Health Peking University\/ National Health Commission Key Laboratory Peking University Beijing China"},{"name":"Department of Epidemiology and Biostatistics School of Public Health Peking University Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenying","family":"Meng","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Child Health Peking University\/ National Health Commission Key Laboratory Peking University Beijing China"},{"name":"Department of Epidemiology and Biostatistics School of Public Health Peking University Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9115-5638","authenticated-orcid":false,"given":"Aiguo","family":"Ren","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Child Health Peking University\/ National Health Commission Key Laboratory Peking University Beijing China"},{"name":"Department of Epidemiology and Biostatistics School of Public Health Peking University Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Jin","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Child Health Peking University\/ National Health Commission Key Laboratory Peking University Beijing China"},{"name":"Department of Epidemiology and Biostatistics School of Public Health Peking University Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,5,31]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0363\u20105023(76)80021\u20104"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102474\u201014\u2010323"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1113"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0194986"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4724"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1302\/1863\u20102548.13.190076"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2015.1107770"},{"issue":"9","key":"e_1_2_9_9_1","first-page":"903","article-title":"A case\u2010control study on genetic and environmental factors regarding polydactyly and syndactyly","volume":"30","author":"Luo JY","year":"2009","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102474\u20108\u201062"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdrc.21140"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199212243272602"},{"key":"e_1_2_9_13_1","unstructured":"WHO.WHO recommendations on antenatal care for a positive pregnancy experience.2016."},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199911113412001"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0187996"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114520001178"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(95)90052\u20107"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a010070"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12354"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/1055665618767115"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000595"},{"issue":"1","key":"e_1_2_9_22_1","first-page":"319","article-title":"Limb anomalies in chromosomal aberrations","volume":"13","author":"Pfeiffer RA","year":"1977","journal-title":"Birth Defects Orig Artic Ser"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11655\u2010015\u20102144\u2010z"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471\u20100528.16458"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20780"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12519\u2010011\u20100328\u2010y"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010cellbio\u2010092910\u2010154048"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/15648265080292S117"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20587"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(99)00085-8"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.30505"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.nutr.19.1.217"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/wsbm.1426"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/71.4.962"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz130"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.03.029"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmr022"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.2105\/ajph.88.10.1554"},{"issue":"7","key":"e_1_2_9_39_1","first-page":"496","article-title":"Prevalence of smoking among residents in Xicheng District, Beijing","volume":"21","author":"Bao CH","year":"2005","journal-title":"Zhong Guo Jian Kang Jiao Yu"}],"container-title":["Paediatric and Perinatal Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ppe.12775","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ppe.12775","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ppe.12775","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T01:41:52Z","timestamp":1693359712000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ppe.12775"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,31]]},"references-count":38,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1111\/ppe.12775"],"URL":"https:\/\/doi.org\/10.1111\/ppe.12775","archive":["Portico"],"relation":{},"ISSN":["0269-5022","1365-3016"],"issn-type":[{"type":"print","value":"0269-5022"},{"type":"electronic","value":"1365-3016"}],"subject":[],"published":{"date-parts":[[2021,5,31]]},"assertion":[{"value":"2021-01-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}