Improvements in the Status of Folate and Cobalamin in Pregnant Newfoundland Women Are Consistent with Observed Reductions in the Incidence of Neural Tube Defects

BackgroundHistorically, the province of Newfoundland and Labrador had one of the highest rates of neural tube defects (NTDs) in North America (1976–1991: 3.2/1000 births), which could be partially explained by the sub-optimal status of folate and cobalamin in this population. In order to gain evidence of the impact of folate fortification programs, as well as prenatal education programs, a cross-sectional study was conducted to obtain data on …