ArticleJournal of global health2026
Association of premarital medical check-ups and folic acid knowledge, attitudes, and practices with the occurrence of neural tube defects in Guangxi, China (2009-2023).
Article in Journal of global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Neural tube defects (NTDs) are severe congenital malformations that cause significant foetal mortality and lifelong disability. Preconception folic acid supplementation has been proven effective in reducing the risk of NTDs. In 2009, China launched a national folic acid supplementation programme, which was further strengthened in Guangxi, China, by the implementation of a free premarital medical check-up policy in 2010. In this study, we analysed NTDs incidence trends in Guangxi (2009-2023) to evaluate the impact of these integrated interventions. Methods: We conducted a descriptive epidemiological study utilising surveillance data from Guangxi on premarital medical check-up (PMC) rate, folic acid supplementation rate, compliance rate, awareness rate, and the number of NTDs cases from 2009 to 2023. We used the Cochran-Armitage trend test to assess temporal trends, and Spearman's rank correlation and linear regression analyses to examine associations between PMC rate, folic acid-related indicators, and the NTDs incidence rate. Results: We observed significant increasing trends in the PMC rate, folic acid supplementation rate, compliance rate, and awareness rate (P < 0.001, respectively) from 2009 to 2023. Conversely, the NTDs incidence rate demonstrated a significant decreasing trend (χ Conclusions: The findings highlight the pivotal role of premarital medical check-ups and folic acid supplementation in preventing NTDs. The sustained promotion and reinforcement of these public health interventions are essential for further reducing the burden of birth defects and improving population health outcomes. The 'Guangxi model' of integrated premarital and reproductive health services offers valuable insights in this context.
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