SynthesisEuropean journal of pediatrics2011
Economic burden of neural tube defects and impact of prevention with folic acid: a literature review.
Synthesis in European journal of pediatrics, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
72 citing papers in PubMed, 8 syntheses or guidelines pooled it, 177 citations in OpenAlex.
- Comparing Folic Acid Interventions and Arsenic Reduction Strategies for Neural Tube Defect Prevention in Bangladesh: A Systematic Review and Decision Analysis.Birth defects research · 2025Pooled it
- Birth prevalence and determinants of neural tube defects among newborns in Ethiopia: A systematic review and meta-analysis.PloS one · 2025Pooled it
- Birth prevalence and risk factors of neural tube defects in Ethiopia: a systematic review and meta-analysis.BMJ open · 2023Pooled it
- Birth prevalence of neural tube defects and associated risk factors in Africa: a systematic review and meta-analysis.BMC pediatrics · 2021Pooled it
- Cost-effectiveness of mandatory folic acid fortification of flours in prevention of neural tube defects: A systematic review.PloS one · 2021Pooled it
- Preconception health interventions delivered in public health and community settings: A systematic review.Canadian journal of public health = Revue canadienne de sante publique · 2017Pooled it
- Global Birth Prevalence of Spina Bifida by Folic Acid Fortification Status: A Systematic Review and Meta-Analysis.American journal of public health · 2016Pooled it
- The prevalence and nature of the use of preconception services by women with chronic health conditions: an integrative review.BMC women's health · 2015Pooled it
- Prevention of congenital malformations and other adverse pregnancy outcomes with 4.0 mg of folic acid: community-based randomized clinical trial in Italy and the Netherlands.BMC pregnancy and childbirth · 2014Trial
- The equity and effectiveness of China's 2009 folic acid supplementation programme for long-term child development.Global health action · 2026Article
- Neural tube defects burden from 1992 to 2021: a global, regional, and national age-period-cohort analysis of disability-adjusted life years.BMC pediatrics · 2026Article
- A systematic review of economic evaluations of community-based healthcare interventions for neurodisability management.Health economics review · 2026Review
- Maternal Folic Acid Supplementation and Neural Tube Defects in Northeast Iran: Insights for Developing Countries.Pediatric health, medicine and therapeutics · 2026Article
- The burden of neural tube defects in Southern Ethiopia: trends, hotspots, and public health implications.PeerJ · 2026Article
- Burden of neural tube defects in the Middle East and North Africa from 1990 to 2021: Findings from the global burden of disease study.Journal of Taibah University Medical Sciences · 2025Article
- National strategies for screening neural tube defects in Saudi Arabia: activating prevention and early intervention.Frontiers in public health · 2025Review
- Association between preconception and early pregnancy exposure to fine particulate matter and nervous system anomalies: a nested case-control study.European journal of epidemiology · 2025Article
- Article
- Craniorachischisis in a 33-week-old Female Fetus: A Case Report.Acta medica Philippina · 2024Article
- Intra-amniotic mesenchymal stem cell therapy improves the amniotic fluid microenvironment in rat spina bifida aperta fetuses.Cell proliferation · 2023Article
12 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Neural tube defects (NTDs) are the second most common group of serious birth defects. Although folic acid has been shown to reduce effectively the risk of NTDs and measures have been taken to increase the awareness, knowledge, and consumption of folic acid, the full potential of folic acid to reduce the risk of NTDs has not been realized in most countries. To understand the economic burden of NTDs and the economic impact of preventing NTDs with folic acid, a systematic review was performed on relevant studies. A total of 14 cost of illness studies and 10 economic evaluations on prevention of NTDs with folic acid were identified. Consistent findings were reported across all of the cost of illness studies. The lifetime direct medical cost for patients with NTDs is significant, with the majority of cost being for inpatient care, for treatment at initial diagnosis in childhood, and for comorbidities in adult life. The lifetime indirect cost for patients with spina bifida is even greater due to increased morbidity and premature mortality. Caregiver time costs are also significant. The results from the economic evaluations demonstrate that folic acid fortification in food and preconception folic acid consumption are cost-effective ways to reduce the incidence and prevalence of NTDs. This review highlights the significant cost burden that NTDs pose to healthcare systems, various healthcare payers, and society and concludes that the benefits of prevention of NTDs with folic acid far outweigh the cost. Further intervention with folic acid is justified in countries where the full potential of folic acid to reduce the risk of NTDs has not been realized.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.