ArticleBMJ open2018
Sex differences in the prevalence of neural tube defects and preventive effects of folic acid (FA) supplementation among five counties in northern China: results from a population-based birth defect surveillance programme.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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
18 citing papers in PubMed, 31 citations in OpenAlex.
- EAU-ESPU-ERN eUROGEN-ERN ITHACA-ERN ERKNet-IFSBH Guidelines on Spinal Dysraphism in Children and Adolescents: Summary of the Guideline.European urology open science · 2026Article
- No Evidence of Impact of Genetic Sex on Hyperthermia-Induced Neural Tube Defects in Chicken Embryos.Birth defects research · 2026Article
- Article
- Human organoids potentially boost research into environmental factors of neural tube defects.Reproductive toxicology (Elmsford, N.Y.) · 2025Review
- Risk factors for neural tube defects in the war and siege-affected tigray regional state of ethiopia: a case-control study.BMC pregnancy and childbirth · 2025Article
- Gastrulation-stage alcohol exposure induces similar rates of craniofacial malformations in male and female C57BL/6J mice.Birth defects research · 2024Article
- Advances in DNA methylation of imprinted genes and folic acid regulation of growth and development.Epigenomics · 2024Review
- Study on the relationship between genetic polymorphism of reductive folic acid carrier and the risk of neural tube defects.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023Article
- Neural tube defects as a cause of death among stillbirths, infants, and children younger than 5 years in sub-Saharan Africa and southeast Asia: an analysis of the CHAMPS network.The Lancet. Global health · 2023Article
- Burden of Neural Tube Defects and Their Associated Factors in Africa: A Systematic Review and Meta-Analysis.International journal of pediatrics · 2023Review
- Neural tube defects among new borns: a cross-sectional study.Frontiers in pediatrics · 2023Article
- Periconceptional folic acid use prevents both rare and common neural tube defects in China.Birth defects research · 2022Article
- Genetic Polymorphisms in DNA Repair Gene APE1/Ref-1 and the Risk of Neural Tube Defects in a High-Risk Area of China.Reproductive sciences (Thousand Oaks, Calif.) · 2021Article
- Closing in on Mechanisms of Open Neural Tube Defects.Trends in neurosciences · 2020Review
- Determinants of Neural Tube Defects among Newborns in Amhara Region, Ethiopia: A Case-Control Study.International journal of pediatrics · 2020Article
- Epidemiology and determinant factors of neural tube defect: Narrative review.Surgical neurology international · 2020Review
- Folate of pregnant women after a nationwide folic acid supplementation in China.Maternal & child nutrition · 2019Article
- Comparison of Intraspinal Abnormalities Prevalence in Congenital Scoliosis: Is Multiple Hemivertebra Associated with Higher Risk than Single Hemivertebra?JB & JS open accessArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 3 countries.
Funding
Abstract
objectivesSex differences in prevalence of neural tube defects (NTDs) have previously been recognised; however, the different susceptibility of men and women have not been examined in relation to the effects of folic acid (FA) supplementation. We hypothesised that FA may have a disproportionate effect that alters the sex-specific prevalence of NTDs.
settingData from two time points, before (2003-2004) and after (2011-2016) the start of the supplementation programme, were obtained from a population-based birth defect surveillance programme among five counties in northern China. All live births (28 or more complete gestational weeks), all stillbirths of at least 20 weeks' gestational age and pregnancy terminations at any gestational age following the prenatal diagnosis of NTDs were included.
participantsA total of 25 249 and 83 996 births before and after the programme were included respectively. PRIMARY AND SECONDARY OUTCOME MEASURES: The prevalence of NTDs by sex and subtype, Male:female rate ratios and their 95% CI were calculated.
resultsOverall, NTDs were less prevalent among men than among women (rate ratio (RR) 0.92; 95% CI 0.90 to 0.94), so was anencephaly (RR 0.77; 95% CI 0.73 to 0.81) and encephalocele (RR 0.75; 95% CI 0.61 to 0.92), while spina bifida showed a male predominance (RR 1.10; 95% CI 1.05 to 1.15). The overall prevalence of NTDs decreased by 78/10 000 in men and 108.7/10 000 in women from 2003 to 2004 to 2011 to 2016. There was a significant sex difference in the magnitude of reduction, being greater in women than men, particularly for anencephaly.
conclusionsThe prevalence of NTDs decreased in both sexes after the implementation of a massive FA supplementation programme. While female predominance was observed in open NTDs and total NTDs, they also had a greater rate of decrease in NTDs after the supplementation programme.
Indexed as
Identifiers
What OpenQuestion holds
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.