Evidence map›Paper›PMID 37875332›Full record

Observational studyArchives of disease in childhood2024

Prevalence of neural tube defects in England prior to the mandatory fortification of non-wholemeal wheat flour with folic acid: a population-based cohort study.

Jennifer M Broughan, Danielle Martin, Thomas Higgins, Gillian Swan, Adrienne Cullum, Jennifer J Kurinczuk, Elizabeth S Draper, Karen Luyt, Diana G Wellesley, Sarah Stevens and 2 more

Abstract readObservational Study
In one paragraph

Observational study in Archives of disease in childhood, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Jennifer M BroughanNational Disease Registration Service (NDRS), NHS England, Redditch, UK jennifer.broughan@nhs.net.ORCID 0000-0002-4450-2147
Danielle MartinNational Disease Registration Service (NDRS), NHS England, Redditch, UK.
Thomas HigginsNational Disease Registration Service (NDRS), NHS England, Redditch, UK.
Gillian SwanOffice for Health Improvement and Disparities, United Kingdom Department of Health and Social Care, London, UK.
Adrienne CullumOffice for Health Improvement and Disparities, United Kingdom Department of Health and Social Care, London, UK.
Jennifer J KurinczukNational Perinatal Epidemiology Unit, University of Oxford, Oxford, UK.
Elizabeth S DraperHealth Sciences, University of Leicester, Leicester, UK.ORCID 0000-0001-9340-8176
Karen LuytTranslational Health Sciences, University of Bristol Medical School, Bristol, UK.ORCID 0000-0002-9806-1092
Diana G WellesleyPsychology, Southampton University Hospitals Trust, Southampton, UK.
Sarah StevensNational Disease Registration Service (NDRS), NHS England, Redditch, UK.
Alison TedstoneOffice for Health Improvement and Disparities, United Kingdom Department of Health and Social Care, London, UK.
Judith RankinNational Disease Registration Service (NDRS), NHS England, Redditch, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo determine the baseline trends in the total birth prevalence of neural tube defects (NTDs) in England (2000-2019) to enable the impact of folic acid fortification of non-wholemeal wheat flour to be monitored.

designPopulation-based, observational study using congenital anomaly (CA) registration data for England curated by the National Congenital Anomaly and Rare Disease Registration Service (NCARDRS).

settingRegions of England with active registration in the time period.

participantsBabies that were liveborn or stillborn and pregnancies that resulted in a termination of pregnancy or a late miscarriage (20-23 weeks' gestation) with an NTD.

main outcome measuresTotal birth prevalence of anencephaly, spina bifida and all NTDs in England. Poisson regression analysis was used to evaluate time trends with regional register as a random effect. The progress of national registration across England was assessed.

resultsThere were 4541 NTD pregnancies out of 3 637 842 births in England; 1982 anencephaly and 2127 spina bifida. NTD prevalence was 12.5 (95% CI 12.1 to 12.9) per 10 000 total births. NTD prevalence per 10 000 total births was significantly higher in 2015-2019 (13.6, 95% CI 12.9 to 14.4) compared with 2010-2014 (12.1, 95% CI 11.7 to 12.5). An increasing trend in NTDs overall was detected (incidence rate ratio (IRR) 1.01, 1.00 to 1.02), although further analysis determined this effect was confined to 2015-2019 (compared against 2000-2004, IRR 1.14, 1.04 to 1.24). The birth prevalence of anencephaly reflected this pattern. The prevalence of spina bifida remained relatively stable over time.

conclusionsBaseline NTD prevalence for England has been established. National and standardised CA registration is in place, facilitating the systematic and consistent monitoring of pre-fortification and post-fortification NTD trends and evaluating the impact of fortification on NTD prevalence.

Indexed as

AnencephalyNeural Tube DefectsSpinal DysraphismCohort StudiesFemaleFlourFolic AcidFood, FortifiedHumansPregnancyPrevalenceTriticumFolic AcidChild HealthEpidemiologyPaediatrics

Identifiers

PMID37875332
PMCPMC10850651

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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.