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The DOI matches its Crossref record; 19 of the 19 references it cites were found in a registry or an index.

Reduction in Neural-Tube Defects after Folic Acid Fortification in Canada

De Wals, Philippe, Tairou, Fassiatou, Van Allen, Margot I., Uh, Soo-Hong, Lowry, R. Brian, Sibbald, Barbara, Evans, Jane A., Van den Hof, Michiel C., Zimmer, Pamela, Crowley, Marian, Fernandez, Bridget, Lee, Nora S., Niyonsenga, Theophile·2007·New England Journal of Medicine
DOI 10.1056/nejmoa067103
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Abstract

BACKGROUND: In 1998, folic acid fortification of a large variety of cereal products became mandatory in Canada, a country where the prevalence of neural-tube defects was historically higher in the eastern provinces than in the western provinces. We assessed changes in the prevalence of neural-tube defects in Canada before and after food fortification with folic acid was implemented. METHODS: The study population included live births, stillbirths, and terminations of pregnancies because of fetal anomalies among women residing in seven Canadian provinces from 1993 to 2002. On the basis of published results of testing of red-cell folate levels, the study period was divided into prefortification, partial-fortification, and full-fortification periods. We evaluated the relationship between baseline rates of neural-tube defects in each province and the magnitude of the decrease after fortification was implemented. RESULTS: A total of 2446 subjects with neural-tube defects were recorded among 1.9 million births. The prevalence of neural-tube defects decreased from 1.58 per 1000 births before fortification to 0.86 per 1000 births during the full-fortification period, a 46% reduction (95% confidence interval, 40 to 51). The magnitude of the decrease was proportional to the prefortification baseline rate in each province, and geographical differences almost disappeared after fortification began. The observed reduction in rate was greater for spina bifida (a decrease of 53%) than for anencephaly and encephalocele (decreases of 38% and 31%, respectively). CONCLUSIONS: Food fortification with folic acid was associated with a significant reduction in the rate of neural-tube defects in Canada. The decrease was greatest in areas in which the baseline rate was high.

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Metadata

Authors
De Wals, P., Tairou, F., Van Allen, M. I., Uh, S.-H., Lowry, R. B., Sibbald, B., Evans, J. A., Van den Hof, M. C., Zimmer, P., Crowley, M., Fernandez, B., Lee, N. S., & Niyonsenga, T.
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2007-07-12
Volume
357
Issue
2
Pages
135-142
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa067103
OpenAlex
W2127935571
Cited by
851
References
19
FWCI
34.33
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Reduction in Neural-Tube Defects after Folic Acid Fortification in Canada. https://app.cochat.ai/papers/10.1056/nejmoa067103
The paper
De Wals, P., Tairou, F., Van Allen, M. I., Uh, S.-H., Lowry, R. B., Sibbald, B., Evans, J. A., Van den Hof, M. C., Zimmer, P., Crowley, M., Fernandez, B., Lee, N. S., & Niyonsenga, T. (2007). Reduction in Neural-Tube Defects after Folic Acid Fortification in Canada. New England Journal of Medicine. https://doi.org/10.1056/nejmoa067103

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.