Evidence map›Paper›PMID 25073783›Full record

ArticleBMJ (Clinical research ed.)2014

Population red blood cell folate concentrations for prevention of neural tube defects: Bayesian model.

Krista S Crider, Owen Devine, Ling Hao, Nicole F Dowling, Song Li, Anne M Molloy, Zhu Li, Jianghui Zhu, Robert J Berry

2 registry-linked trialsOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ (Clinical research ed.), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 99 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
99citing papers in PubMed, 5 pooled it
16.6field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT04310059 naunknown statusnot on this mapstarted 2024, after this paper: background citation

A Randomized Controlled Trial to Study the Effect of Folic Acid Supplementation in Pregnant Women Having Thalassaemia Trait

TypeinterventionalSponsorThe University of Hong KongRan2024 to 2026Enrolled270ConditionsThalassemia, Folic Acid Deficiency AnemiaArmsFolic acid, Materna
NCT05935631 nacompletednot on this mapstarted 2023, after this paper: background citation

Feasibility, Acceptability and Directional Signal Effect on Blood Folate Levels of Iodized Salt Fortified With Folic Acid: Clinical Study

TypeinterventionalSponsorUniversity of Alabama at BirminghamRan2023 to 2023Enrolled32ConditionsNeural Tube Defects, Folic Acid Deficiency, FortificationArmsSalt with folic acid and iodine
3 · Its place in the literature

Who cites it

99 citing papers in PubMed, 5 syntheses or guidelines pooled it, 203 citations in OpenAlex.

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39 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 3 countries.

Krista S CriderNational Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA kcrider@cdc.gov.
Owen DevineNational Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Ling HaoPeking University Health Science Center, Peking University, Beijing, China US Centers for Disease Control and Prevention, US Embassy, Beijing, China.
Nicole F DowlingNational Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Song LiPeking University Third Hospital, Beijing, China.
Anne M MolloySchool of Medicine, Trinity College, Dublin, Ireland.
Zhu LiPeking University Health Science Center, Peking University, Beijing, China.
Jianghui ZhuPeking University Health Science Center, Peking University, Beijing, China Division of Risk Assessment, China National Center for Food Safety Risk Assessment, Beijing, China.
Robert J BerryNational Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
National Center on Birth Defects and Developmental Disabilities · USPeking University · CNCenters for Disease Control and Prevention · USTrinity College Dublin · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine an optimal population red blood cell (RBC) folate concentration for the prevention of neural tube birth defects.

designBayesian model.

settingData from two population based studies in China.

participants247,831 participants in a prospective community intervention project in China (1993-95) to prevent neural tube defects with 400 μg/day folic acid supplementation and 1194 participants in a population based randomized trial (2003-05) to evaluate the effect of folic acid supplementation on blood folate concentration among Chinese women of reproductive age.

interventionFolic acid supplementation (400 μg/day).

main outcome measuresEstimated RBC folate concentration at time of neural tube closure (day 28 of gestation) and risk of neural tube defects.

resultsRisk of neural tube defects was high at the lowest estimated RBC folate concentrations (for example, 25.4 (95% uncertainty interval 20.8 to 31.2) neural tube defects per 10,000 births at 500 nmol/L) and decreased as estimated RBC folate concentration increased. Risk of neural tube defects was substantially attenuated at estimated RBC folate concentrations above about 1000 nmol/L (for example, 6 neural tube defects per 10,000 births at 1180 (1050 to 1340) nmol/L). The modeled dose-response relation was consistent with the existing literature. In addition, neural tube defect risk estimates developed using the proposed model and population level RBC information were consistent with the prevalence of neural tube defects in the US population before and after food fortification with folic acid.

conclusionsA threshold for "optimal" population RBC folate concentration for the prevention of neural tube defects could be defined (for example, approximately 1000 nmol/L). Population based RBC folate concentrations, as a biomarker for risk of neural tube defects, can be used to facilitate evaluation of prevention programs as well as to identify subpopulations at elevated risk for a neural tube defect affected pregnancy due to folate insufficiency.

Indexed as

Bayes TheoremErythrocytesFemaleFolic AcidFolic Acid DeficiencyGenotypeHematinicsHumansMethylenetetrahydrofolate Reductase (NADPH2)Neural Tube DefectsPregnancyPrenatal CareProspective StudiesRandomized Controlled Trials as TopicFolic AcidHematinicsMethylenetetrahydrofolate Reductase (NADPH2)MTHFR protein, human

Identifiers

PMID25073783
PMCPMC4115151
OpenAlexW2075921398

What OpenQuestion holds

Textmetadata
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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.