{"id":"4c9c3101-3693-55bf-8181-f9b0369ce30c","stable_key":"ec174d5a-4903-5745-8646-df0e9d4265e8:fol-ntd-first-occurrence-multivitamin","predicate":"was_component_of_effective_multivitamin","statement":"The Hungarian trial observed zero NTDs among 2104 known-outcome multivitamin pregnancies and six among 2052 trace-element pregnancies (P=0.029).","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"negative","is_public":true,"mechanism_event_id":"f3fd1eb6-4faa-596d-bbbd-06fc68fc1754","mechanism_event_label":"The supplement containing folic acid reduced first occurrences, but it also contained other vitamins and minerals.","subject":{"id":"d322bfef-5135-599f-82e6-0aa58748dc8b","slug":"folic-acid","display_name":"Folic acid","entity_type_key":"small_molecule"},"object":{"id":"763ed160-e614-5def-8cbe-16ecb2e2d003","slug":"neural-tube-defect-incidence","display_name":"Neural-tube defect incidence","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"f3fd1eb6-4faa-596d-bbbd-06fc68fc1754","stable_key":"ec174d5a-4903-5745-8646-df0e9d4265e8:fol-ntd-first-occurrence-multivitamin-event","event_type":"observed_intervention","label":"The supplement containing folic acid reduced first occurrences, but it also contained other vitamins and minerals.","description":"The Hungarian trial observed zero NTDs among 2104 known-outcome multivitamin pregnancies and six among 2052 trace-element pregnancies (P=0.029).","status":"provisional","compartment":null,"participants":[{"entity":{"id":"d322bfef-5135-599f-82e6-0aa58748dc8b","slug":"folic-acid","display_name":"Folic acid","entity_type_key":"small_molecule"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"763ed160-e614-5def-8cbe-16ecb2e2d003","slug":"neural-tube-defect-incidence","display_name":"Neural-tube defect incidence","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""}]},"contexts":[{"dimension":"cross_nutrient","value_text":"Cointervention with multiple vitamins and minerals is retained explicitly.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"Randomized Hungarian first-occurrence prevention trial; known outcomes in 2104 multivitamin and 2052 trace-element recipients.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"Multivitamin including 0.8 mg folic acid versus trace elements with low vitamin C; at least one month before conception through second missed period or later.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"The randomized comparison cannot assign its entire effect to folic acid alone or demonstrate equivalence of other folate formulations.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Folate and folic acid research collection; topical membership is not evidence of a direct dietary effect.","comparator":null,"unit":null,"notes":"","entity":{"slug":"folate","display_name":"Folate (vitamin B9)","entity_type_key":"chemical_species"}},{"dimension":"organism","value_text":"Homo sapiens","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"The supplement containing folic acid reduced first occurrences, but it also contained other vitamins and minerals.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[fol-czeizel1992] Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation (1992). https://pubmed.ncbi.nlm.nih.gov/1307234/ DOI: 10.1056/nejm199212243272602","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Pregnancy and fetal developmental outcomes","comparator":null,"unit":null,"notes":"","entity":null}],"evidence":[{"id":"82126e76-0c6a-531a-9ca1-34942441a884","evidence_kind":"source_excerpt","locator":"Lines 1371-1382","start_line":1371,"end_line":1382,"excerpt":"### fol-ntd-first-occurrence-multivitamin\nThe Hungarian trial observed zero NTDs among 2104 known-outcome multivitamin pregnancies and six among 2052 trace-element pregnancies (P=0.029).\nCondition category: normal\nnutrient_topic: Folate and folic acid research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: The supplement containing folic acid reduced first occurrences, but it also contained other vitamins and minerals.\norganism: Homo sapiens\ntissue_or_cell_type: Pregnancy and fetal developmental outcomes\nexperimental_model: Randomized Hungarian first-occurrence prevention trial; known outcomes in 2104 multivitamin and 2052 trace-element recipients.\nlimitations: The randomized comparison cannot assign its entire effect to folic acid alone or demonstrate equivalence of other folate formulations.\nexposure: Multivitamin including 0.8 mg folic acid versus trace elements with low vitamin C; at least one month before conception through second missed period or later.\ncross_nutrient: Cointervention with multiple vitamins and minerals is retained explicitly.\n[fol-czeizel1992] Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation (1992). https://pubmed.ncbi.nlm.nih.gov/1307234/ DOI: 10.1056/nejm199212243272602","model_system":"Randomized Hungarian first-occurrence prevention trial; known outcomes in 2104 multivitamin and 2052 trace-element recipients.","directness":"author_interpretation","verification_status":"source_derived_draft","notes":"Exact curation-document quotation, not publisher quotation. Study references: [fol-czeizel1992] Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation (1992). https://pubmed.ncbi.nlm.nih.gov/1307234/ DOI: 10.1056/nejm199212243272602","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"f4ce1a62-9582-5f7a-84f5-a23d0e1bfc68","stable_key":"import-ec174d5a-4903-5745-8646-df0e9d4265e8","title":"Folate and folic acid: mechanisms, deficiency and nutrient interactions (2026-09-17)","document_type":"imported_text","citation_label":"AI-assisted literature curation; primary study URLs and scope retained in the document and extraction. Not publisher full text.","file_path":"","sha256":"e564d43989ece1006c95cd0748e9af6fe369074599a2eebba0a99ebff864b0dd","revision_id":"76674a33-b2a1-5e41-b71b-44399038ff7c","review_status":"unverified_draft","notes":""}}],"relations":[],"conflicts":[],"corrections":[],"research":null}