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. 2016 Jan;106(1):e24–e34. doi: 10.2105/AJPH.2015.302902

TABLE 2—

Summary of Meta-Analysis Results Regarding Spina Bifida per 100 000 Births by Birth Population and Fortification Status: World Population, 1985–2010

Variable and Group No. of Studies Estimate per 100 000 Births (95% CI)
Fortification: mandatory
 LB 14 33.86 (31.05, 36.92)
 LB + SB 13 30.37 (27.42, 33.63)
 LB + SB + TOP 14 35.22 (32.18, 38.56)
Fortification: not mandatory
 LB 34 48.35 (41.07, 56.93)
 LB + SB 37 47.74 (43.66, 52.20)
 LB + SB + TOP 49 52.29 (46.28, 59.08)
Continent: Africa
 LB 2 78.18 (30.66, 202.55)
 LB + SB 1 54.32 (36.71, 80.39)
 LB + SB + TOP . . . . . .
Continent: Asia
 LB 6 81.37 (35.05, 188.90)
 LB + SB 14 87.99 (66.83, 115.86)
 LB + SB + TOP 4 243.14 (48.34, 1223.04)
Continent: Australia
 LB 1 37.69 (10.51, 135.21)
 LB + SB 1 51.48 (42.98, 61.66)
 LB + SB + TOP 4 61.66 (51.44, 73.91)
Continent: Europe
 LB 5 59.76 (39.19, 91.12)
 LB + SB 2 59.54 (32.98, 107.49)
 LB + SB + TOP 22 52.73 (45.43, 61.21)
Continent: North America
 LB 29 36.87 (34.36, 39.55)
 LB + SB 23 36.08 (33.50, 38.87)
 LB + SB + TOP 29 38.70 (34.41, 43.53)
Continent: South America
 LB . . . . . .
 LB + SB 3 81.33 (59.56, 111.06)
 LB + SB + TOP . . . . . .

Notes. CI = confidence interval; LB = live birth; SB = stillbirth; TOP = termination of pregnancy. The pooled period prevalence of spina bifida in studies reporting on live births, stillbirths, and terminations of pregnancy was lower in regions with mandatory folic acid fortification than in those without (35.22 per 100 000 live births compared with 52.29 per 100 000 live births, respectively).