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Investigators from the Greenwood Genetic Center in South Carolina conducted an ecological study to assess the impact of folic acid fortification of cereal grain products on rates and types of neural tube defects (NTD) in South Carolina. Cases of NTD-affected pregnancies, fetuses, and infants were obtained from South Carolina’s genetic referral services, prenatal diagnostic centers, obstetrician offices, maternal alpha-fetoprotein laboratories, and delivery hospital medical records. NTDs were defined as anencephaly, spina bifida, and encephalocele and could be either isolated or non-isolated. Non-isolated NTDs were grouped into 2 categories: those that were accompanied by birth defects with known causes or that consisted of a recognizable pattern of malformation, and …
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