{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T10:10:53Z","timestamp":1790763053607,"version":"4.1.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T00:00:00Z","timestamp":1707177600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T00:00:00Z","timestamp":1707177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Folic acid supplementation is recommended for reducing the risk of birth defects. We aimed to assess the protective association of periconception folic acid supplements with birth defects in real-world setting.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This prospective, population-based cohort study utilized national preconception registered data of married Chinese couples planning a pregnancy within 6\u2009months between 2010 and 2012 in Mainland China. Participated women are freely provided folic acid starting 3\u2009months before conception till 3\u2009months after conception. Birth defects were self-reported at 42\u2009days postpartumn followup. R software (v4.0.2) was applied for statistical analyses.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Complete data of 567,547 couples with pregnancy outcomes and folic acid supplementation were extracted for final analysis. A total of 74.7% women were with folic acid supplementation, and 599 birth defects were self-reported. The odd of birth defects was lower among women taking folic acid compared to their counterparts not taking (0.102% vs 0.116%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). In the multiple logistic regression analyses, the odd of birth defects was lower among couples with maternal folic acid supplementation (OR\u2009=\u20090.78, 95%CI: 0.66\u20130.95, <jats:italic>P<\/jats:italic>\u00a0=\u20090.011), especially decreased odd of neural tube defects (NTDs) (OR\u2009=\u20090.56, 95%CI: 0.39\u20130.82, <jats:italic>P<\/jats:italic>\u00a0=\u20090.003). This association was confirmed by 1:4 and 1:10 case control analysis. Odds of birth defects were significantly lower among women with folic acid supplementation more than 3 months before pregnancy (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), and moreover, the odds of cleft (<jats:italic>P<\/jats:italic>\u00a0=\u20090.007) and NTDs (<jats:italic>P<\/jats:italic>\u00a0=\u20090.007) were of notable decrease.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This retrospective case cohort study provides programmatic evidence for public health strategy-making to for reducing the risk of NTDs and clefts.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12884-024-06283-8","type":"journal-article","created":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T10:02:12Z","timestamp":1707213732000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Preconception folic acid supplementation for the prevention of birth defects: a prospective, population-based cohort study in mainland China"],"prefix":"10.1186","volume":"24","author":[{"given":"Qiongjie","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guiying","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaomei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiping","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiping","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shikun","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingqi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaotian","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,6]]},"reference":[{"issue":"9","key":"6283_CR1","doi-asserted-by":"publisher","first-page":"632","DOI":"10.7326\/0003-4819-150-9-200905050-00010","volume":"150","author":"T Wolff","year":"2009","unstructured":"Wolff T, Witkop CT, Miller T, Syed SB, U.S. Preventive Services Task Force. Folic acid supplementation for the prevention of neural tube defects: an update of the evidence for the U.S. preventive services task force. Ann Intern Med. 2009;150(9):632\u20139.","journal-title":"Ann Intern Med"},{"issue":"7","key":"6283_CR2","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1056\/NEJM198908173210704","volume":"321","author":"JL Mills","year":"1989","unstructured":"Mills JL, Rhoads GG, Simpson JL, et al. National Institute of Child Health and Human Development neural tube defects study group. The absence of a relation between the periconceptional use of vitamins and neural-tube defects. N Engl J Med. 1989;321(7):430\u20135.","journal-title":"N Engl J Med"},{"issue":"26","key":"6283_CR3","doi-asserted-by":"publisher","first-page":"1832","DOI":"10.1056\/NEJM199212243272602","volume":"327","author":"AE Czeizel","year":"1992","unstructured":"Czeizel AE, Dud\u00e1s I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med. 1992;327(26):1832\u20135.","journal-title":"N Engl J Med"},{"issue":"20","key":"6283_CR4","doi-asserted-by":"publisher","first-page":"2847","DOI":"10.1001\/jama.1989.03430200091032","volume":"262","author":"A Milunsky","year":"1989","unstructured":"Milunsky A, Jick H, Jick SS, et al. Multivitamin\/folic acid supplementation in early pregnancy reduces the prevalence of neural tube defects. JAMA. 1989;262(20):2847\u201352.","journal-title":"JAMA."},{"issue":"1","key":"6283_CR5","first-page":"1","volume":"64","author":"J Williams","year":"2015","unstructured":"Williams J, Mai CT, Mulinare J, et al. Centers for Disease Control and Prevention. Updated estimates of neural tube defects prevented by mandatory folic acid fortification\u2014United States, 1995-2011. MMWR Morb Mortal Wkly Rep. 2015;64(1):1\u20135.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"3","key":"6283_CR6","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/S0749-3797(01)00261-6","volume":"20","author":"RP Harris","year":"2001","unstructured":"Harris RP, Helfand M, Woolf SH, et al. Methods work group, third US preventive services task force. Current methods of the US preventive services task force: a review of the process. Am J Prev Med. 2001;20(3):21\u201335.","journal-title":"Am J Prev Med."},{"issue":"1","key":"6283_CR7","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1093\/aje\/kwn331","volume":"169","author":"BS Mosley","year":"2009","unstructured":"Mosley BS, Cleves MA, Siega-Riz AM, et al. National birth defects prevention study. Neural tube defects and maternal folate intake among pregnancies conceived after folic acid fortification in the United States. Am J Epidemiol. 2009;169(1):9\u201317.","journal-title":"Am J Epidemiol"},{"issue":"2","key":"6283_CR8","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1001\/jama.2016.19193","volume":"317","author":"M Viswanathan","year":"2017","unstructured":"Viswanathan M, Treiman KA, Kish-Doto J, et al. Folic acid supplementation for the prevention of neural tube defects: an updated evidence report and systematic review for the US preventive services task force. JAMA. 2017;317(2):190\u2013203.","journal-title":"JAMA."},{"issue":"1","key":"6283_CR9","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1186\/s12913-016-1930-4","volume":"16","author":"Q Zhou","year":"2016","unstructured":"Zhou Q, Zhang S, Wang Q, et al. China\u2019s community-based strategy of universal preconception care in rural areas at a population level using a novel risk classification system for stratifying couples\u00b4 preconception health status. 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Am J Prev Med. 2010;38(5):534\u201342.","journal-title":"Am J Prev Med"}],"container-title":["BMC Pregnancy and Childbirth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-024-06283-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12884-024-06283-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-024-06283-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T10:03:06Z","timestamp":1707213786000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpregnancychildbirth.biomedcentral.com\/articles\/10.1186\/s12884-024-06283-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,6]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["6283"],"URL":"https:\/\/doi.org\/10.1186\/s12884-024-06283-8","relation":{},"ISSN":["1471-2393"],"issn-type":[{"value":"1471-2393","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,6]]},"assertion":[{"value":"16 September 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 February 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This project was approved by the Chinese Association of Maternal and Child Health Studies (IRB-201001), and written informed consent was obtained from each participant before enrollment. For those participated couples who were illiterate, their finger print was taken for the informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"114"}}