Research Topics
Species | J G RaySummaryAffiliation: McMaster University Country: Canada Publications
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Publications
Declining rate of folate insufficiency among adults following increased folic acid food fortification in CanadaJ G Ray
Department of Medicine, Sunnybrook and Women s College Health Sciences Centre, Toronto, ON
Can J Public Health 93:249-53. 2002..We investigated whether the rate of folate and vitamin B12 insufficiency among adults has changed since this mandatory fortification program was implemented...- Anticonvulsant drug use and low bone mass in adults with neurodevelopmental disordersJ G Ray
Sunnybrook and Women s College Health Science Centre, Toronto, Canada
QJM 95:219-23. 2002..Use of anticonvulsant drugs among adults with neurodevelopmental disorders may be an important risk factor for both osteoporosis and skeletal fractures... 
Use of a rapid arterial blood gas analyzer to estimate blood hemoglobin concentration among critically ill adultsJoel G Ray
Division of Critical Care, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Crit Care 6:72-5. 2002..To evaluate whether measurement of the hemoglobin (Hb) concentration with a blood gas analyzer approximates that determined by a conventional coulter counter in critically ill adults...- Association between folic acid food fortification and hypertension or preeclampsia in pregnancyJoel G Ray
Toronto, Ontario
Arch Intern Med 162:1776-7. 2002 - Antipsychotic and antidepressant drug use in the elderly and the risk of venous thromboembolismJoel G Ray
Department of Medicine, Sunnybrook and Women s College Health Sciences Centre, Toronto, Ontario
Thromb Haemost 88:205-9. 2002..Preliminary evidence suggests that use of antipsychotic drugs is associated with an increased risk of venous thromboembolism... - Common C677T polymorphism of the methylenetetrahydrofolate reductase gene and the risk of venous thromboembolism: meta-analysis of 31 studiesJ G Ray
Department of Medicine, Women s College Campus, Sunnybrook and Women s College Health Sciences Centre, Toronto, Ont, Canada
Pathophysiol Haemost Thromb 32:51-8. 2002..We conducted a meta-analysis of previously published studies to clarify the role of the MTHFR 677 TT homozygous genotype in association with VTE... - Why might statins prevent venous thromboembolism: what needs to be done to know more?Joel G Ray
Department of Medicine, Sunnybrook and Women s College Health Sciences Centre, Toronto, Ontario, Canada
Expert Opin Investig Drugs 11:1659-68. 2002..The current review outlines the cumulative evidence from both the basic and epidemiologic sciences for why this might be so and offers some directions for future research... - Increased blood product use among coronary artery bypass patients prescribed preoperative aspirin and clopidogrelJoel G Ray
Division of Critical Care, Department of Medicine, McMaster University, Hamilton, Canada
BMC Cardiovasc Disord 3:3. 2003..We evaluated the associated risk between the combined use of aspirin and clopidogrel and the transfusion of blood products perioperatively... - Dyslipidemia, statins, and venous thromboembolism: a potential risk factor and a potential treatmentJoel G Ray
Department of Medicine, St Michael s Hospital, University of Toronto, Toronto, Ontario, Canada
Curr Opin Pulm Med 9:378-84. 2003..Until then, the efficacy of statins for the prevention or treatment of venous thromboembolism remains uncertain... - Evidence in upheaval: incorporating observational data into clinical practiceJoel G Ray
Arch Intern Med 162:249-54. 2002 - Preconception care and the risk of congenital anomalies in the offspring of women with diabetes mellitus: a meta-analysisJ G Ray
Division of Obstetrical Medicine, Department of Medicine, Women s College Campus, Sunnybrook and Women s College Health Sciences Centre, Toronto, Ontario, Canada
QJM 94:435-44. 2001.... - Paroxysmal nocturnal hemoglobinuria and the risk of venous thrombosis: review and recommendations for management of the pregnant and nonpregnant patientJ G Ray
Department of Medicine, and Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
Haemostasis 30:103-17. 2000.... - MOS HIP: McMaster outcome study of hypertension in pregnancyJ G Ray
Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Early Hum Dev 64:129-43. 2001..The risk of developing these outcomes among women with either preeclampsia or chronic hypertension, relative to those with gestational hypertension, is not known... - Use of statins and the subsequent development of deep vein thrombosisJ G Ray
Department of Medicine, Institute for Clinical Evaluative Sciences, University of Toronto, Ontario
Arch Intern Med 161:1405-10. 2001..Some of the benefit of statins for the prevention of cardiovascular disease may be due to their antithrombotic properties. Little is known about the effect of these drugs on the development of deep vein thrombosis... 
Myocardial infarction associated with recency of immigration to OntarioG Saposnik
Department of Medicine, St Michael s Hospital, University of Toronto, Toronto, Ontario, Canada
QJM 103:253-8. 2010..OBJECTIve: To determine the risk of AMI among new immigrants compared to long-term residents, and, among those who develop AMI, their short- and long-term mortality rate...- Persistence of vitamin B12 insufficiency among elderly women after folic acid food fortificationJ G Ray
Department of Medicine, Sunnybrook and Women s College Health Science Centre, Toronto, Ontario, Canada
Clin Biochem 36:387-91. 2003..To estimate the associated risk of folate and vitamin B12 (B12) insufficiency, as well as vitamin repletion, following folic acid food fortification... - Deep vein thrombosis and its prevention in critically ill adultsJ Attia
Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Arch Intern Med 161:1268-79. 2001..More potent prophylactic regimens other than unfractionated or low-molecular-weight heparins alone may be needed with higher-risk groups... - High rate of maternal vitamin B12 deficiency nearly a decade after Canadian folic acid flour fortificationJ G Ray
Department of Medicine, St Michael s Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada
QJM 101:475-7. 2008..4 (1.1-1.8) after 28 days gestation. About 1 in 20 women may be deficient in B12 in early pregnancy. The impact on maternal and fetal well-being, including preventable NTD, should be considered... - Risk of premature stroke in recent immigrants (PRESARIO): population-based matched cohort studyG Saposnik
Division of Neurology, Department of Medicine, St Michael s Hospital, University of Toronto, 55 Queen St E, Toronto, Ontario, M5C 1R6, Canada
Neurology 74:451-7. 2010..We determined the risk of acute stroke associated with recency of immigration... - Maternal and neonatal outcomes in pregestational and gestational diabetes mellitus, and the influence of maternal obesity and weight gain: the DEPOSIT study. Diabetes Endocrine Pregnancy Outcome Study in TorontoJ G Ray
Department of Medicine, University of Toronto, Canada
QJM 94:347-56. 2001.... - Platelet count may predict abnormal bleeding time among pregnant women with hypertension and preeclampsiaR J McDonagh
Department of Obstetrics and Gynecology, St Joseph s Hospital and McMaster University, Hamilton, Ontario, Canada
Can J Anaesth 48:563-9. 2001..Many rely on the bleeding time (BT) in making this determination. We examined whether the platelet count can adequately predict BT among a group of hypertensive parturients... - Folic acid and homocyst(e)ine metabolic defects and the risk of placental abruption, pre-eclampsia and spontaneous pregnancy loss: A systematic reviewJ G Ray
Obstetrical Medicine Programme, Department of Medicine, University of Toronto, Ontario
Placenta 20:519-29. 1999.... - Sex-specific basis of severe placental dysfunction leading to extreme preterm deliveryM G Walker
Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
Placenta 33:568-71. 2012.... - Risk of congenital anomalies detected during antenatal serum screening in women with pregestational diabetesJ G Ray
Department of Medicine, Inner City Health Research Unit, St Michael s Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada
QJM 97:651-3. 2004..Most studies comparing women with and without pregestational diabetes mellitus have not systematically screened for fetal anomalies in early pregnancy, potentially leading to selection bias... - Venous thromboembolism in association with features of the metabolic syndromeJ G Ray
Department of Medicine, St Michael s Hospital, University of Toronto, Ontario M5B 1W8, Canada
QJM 100:679-84. 2007..However, whether each of these factors additively increases the risk of VTE is uncertain... - Brief overview of maternal triglycerides as a risk factor for pre-eclampsiaJ G Ray
Department of Medicine, St Michael s Hospital, University of Toronto, Toronto, Ontario, Canada
BJOG 113:379-86. 2006..Features of the metabolic syndrome-maternal obesity, diabetes mellitus and chronic hypertension-are risk factors for pre-eclampsia... - Do we care if statins prevent venous thromboembolism?J G Ray
Department of Medicine, St Michael s Hospital, University of Toronto, Toronto, ON, Canada
J Thromb Haemost 2:695-6. 2004 - Survey of cardiac surgeons' perceptions of the addition of ASA to warfarin for patients with mechanical heart valvesJ G Ray
Department of Medicine, McMaster University, Hamilton, Ontario
Can J Cardiol 13:1162-5. 1997..Most surgeons avoid ASA out of concern for the increased risk of hemorrhage and a belief that there is no benefit. These perceptions are not supported by recent scientific data, however... - Association between Bell's palsy in pregnancy and pre-eclampsiaD Shmorgun
Department of Medicine, Sunnybrook and Women's College Health Science Centre, Toronto, Ontario, Canada
QJM 95:359-62. 2002..Pregnant women who develop Bell's palsy should be closely monitored for hypertension or pre-eclampsia, and managed accordingly... - Suspected pulmonary embolism in pregnancy: clinical presentation, results of lung scanning, and subsequent maternal and pediatric outcomesW S Chan
Department of Medicine, Women's College Campus, Sunnybrook and Women's College Health Sciences Centre, 76 Grenville St, Toronto, Ontario, Canada M5S 1B2
Arch Intern Med 162:1170-5. 2002..In addition, pediatric risks from VQ scans are low. Large prospective studies are needed to evaluate diagnostic strategies for pregnant women with suspected PE... - Vitamin B12 insufficiency and the risk of fetal neural tube defectsJ G Ray
Division of Obstetrical Medicine, Department of Medicine, Sunnybrook and Women s College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
QJM 96:289-95. 2003..Although maternal folate insufficiency is a risk factor for fetal neural tube defects (NTDs), there is controversy about whether vitamin B12 (B12) insufficiency is also associated with an increased risk of NTDs... - Estimating gestational age at birth: a population-based derivation-validation studyM L Urquia
Centre for Research on Inner City Health, The Keenan Research Centre of the Li Ka Shing Knowledge Institute, St Michael s Hospital, Toronto, Ontario, Canada
Chronic Dis Inj Can 31:103-8. 2011..We developed and validated a GA prediction model for singleton births for use in epidemiological studies... - Pilot study of the accuracy of bedside glucometry in the intensive care unitJ G Ray
Division of Critical Care, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Crit Care Med 29:2205-7. 2001.... - Risk of stillbirth at extremes of birth weight between 20 to 41 weeks gestationJ G Ray
Department of Medicine, St Michael s Hospital, University of Toronto, Toronto, Ontario, Canada
J Perinatol 32:829-36. 2012..To determine the risk of stillbirth between 20 to 41 weeks gestation, at highly detailed weight percentiles, including extreme degrees of small (SGA) and large (LGA) for gestational age birth weight... - Dose-reducing H2 receptor antagonists in the presence of low glomerular filtration rate: a systematic review of the evidenceJ Manlucu
Division of Nephrology, University of Western Ontario, London, Ontario, Canada
Nephrol Dial Transplant 20:2376-84. 2005..Quality assurance programmes, which improve deficiencies in H2RAs prescribing, appear justified... - Sample size estimation for the sorcerer's apprentice. Guide for the uninitiated and intimidatedJ G Ray
Department of Medicine, Women s College Hospital, Ont
Can Fam Physician 45:1732-9. 1999..To review the importance of and practical application of sample size determination for clinical studies in the primary care setting... - Prevalence of trisomy 21 following folic acid food fortificationJoel G Ray
Department of Medicine, Sunnybrook and Women s College Health Sciences Centre, University of Toronto, Ontario, Canada
Am J Med Genet A 120:309-13. 2003..24). In conclusion, we failed to observe a decline in the occurrence of trisomy 21 following folic acid food fortification... - Vitamin B12 and homocysteineJoel G Ray
CMAJ 173:1359-60. 2005 - Retinal vein occlusion and traditional risk factors for atherosclerosisPaul R A O'Mahoney
School of Medicine, Royal College of Surgeons in Ireland, Dublin
Arch Ophthalmol 126:692-9. 2008..To determine whether retinal vein occlusion (RVO) is related to systemic hypertension, diabetes mellitus, and hyperlipidemia... - Statins and the risk of idiopathic venous thromboembolismJoel G Ray
Br J Clin Pharmacol 56:460; author reply 461-2. 2003 - Efficacy of Canadian folic acid food fortificationJoel G Ray
Department of Medicine, St Michael s Hospital, University of Toronto, Toronto, Ontario, Canada
Food Nutr Bull 29:S225-30. 2008..The current paper describes how this took place, and the epidemiological effects that occurred in the Canadian population, including higher blood folate levels and a decline in the prevalence of neural tube defects... - Homocysteine-lowering therapy and risk for venous thromboembolism: a randomized trialJoel G Ray
Department of Medicine, St Michael s Hospital, University of Toronto, Toronto, Ontario, Canada
Ann Intern Med 146:761-7. 2007..Elevated total homocysteine levels are associated with a higher risk for venous thromboembolism. Whether decreasing homocysteine levels with vitamin therapy reduces the risk for venous thromboembolism is not known... - Vitamin B12 and the risk of neural tube defects in a folic-acid-fortified populationJoel G Ray
Department of Medicine, St Michael s Hospital, University of Toronto, Toronto, Ontario, Canada
Epidemiology 18:362-6. 2007..Prior studies used relatively insensitive measures of B(12), did not adjust for folate levels, and were conducted in countries without folic acid food fortification. In Canada, flour has been fortified with folic acid since mid-1997... - Folic acid food fortification is associated with a decline in neuroblastomaAmy E French
Motherrisk Program and Division of Hematology and Oncology, The Hospital for Sick Children, and Department of Medicine and Prehospital Care Programme, Sunnybrook and Women's College Health Sciences Center, University of Toronto, Ontario, Canada
Clin Pharmacol Ther 74:288-94. 2003..Further investigation is needed into the role of metabolism in the formation and prevention of neuroblastoma and other embryonically determined cancers... - Randomized clinical trial of homocysteine level lowering therapy and fracturesAnna M Sawka
Toronto General Hospital, 200 Elizabeth St, 12-212 Eaton North, Toronto, Ontario M5G 2C4, Canada
Arch Intern Med 167:2136-9. 2007 - Maternal body mass index and the risk of preeclampsia: a systematic overviewTara E O'Brien
Division of Obstetrical Medicine, Department of Medicine, Sunnybrook and Women s College Health Sciences Centre, Toronto, Ontario, Canada
Epidemiology 14:368-74. 2003..We performed a systematic overview of the literature to determine the association between prepregnancy body mass index and the risk of preeclampsia... - Absence of effect of folic acid flour fortification on anticonvulsant drug levelsJoel G Ray
Am J Med 118:444-5. 2005 - Association of neural tube defects and folic acid food fortification in CanadaJoel G Ray
Department of Medicine, Sunnybrook and Women s College Health Sciences Center, Toronto, Ontario, Canada
Lancet 360:2047-8. 2002..58 per 1000 pregnancies thereafter (prevalence ratio 0.52, 95% CI 0.40-0.67, p<0.0001). At a population level, folic acid food fortification is associated with a pronounced reduction in open neural tube defects... - Folic acid and placental pathologySarah D McDonald
Epidemiology 16:419-20. 2005 - Antifibrinolytics may be cost saving among recent recipients of combined acetylsalicylic acid and clopidogrel who undergo coronary artery bypass graft surgeryJoel G Ray
Can J Cardiol 20:829-30. 2004 - Folic acid food fortification in CanadaJoel G Ray
Department of Medicine, St Michael s Hospital, University of Toronto, Toronto, Ontario, Canada
Nutr Rev 62:S35-9. 2004..The current report outlines some of the changes to the health status of Canadians in relation to its folic acid food fortification initiative... - Association between folic acid food fortification and congenital orofacial cleftsJoel G Ray
Department of Laboratory Medicine, University of Toronto, Toronto, Ontario, Canada
J Pediatr 143:805-7. 2003..15 per 1000) to after (1.21 per 1000) food fortification (prevalence ratio, 1.06; 95% confidence interval, 0.86-1.30)... - Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic TherapyWilliam H Geerts
Thromboembolism Program, Sunnybrook and Women's College Health Sciences Centre, Room D674, 2075 Bayview Ave, Toronto, ON, Canada M4N 3M5
Chest 126:338S-400S. 2004..We recommend, on admission to the intensive care unit, all patients be assessed for their risk of VTE. Accordingly, most patients should receive thromboprophylaxis (Grade 1A)... - Taking ACE inhibitors during early pregnancy: is it safe?Joel G Ray
Department of Medicine, University of Toronto, Toronto, Canada
Can Fam Physician 53:1439-40. 2007..We believe this study had serious limitations that preclude drawing any conclusions at present... - Statin use and survival outcomes in elderly patients with heart failureJoel G Ray
Department of Medicine, St Michaels Hospital, University of Toronto, Ontario M5B 1W8, Canada
Arch Intern Med 165:62-7. 2005..Coronary artery disease is a leading cause of heart failure. Statins are efficacious drugs for the primary and secondary prevention of coronary heart disease, but their value in persons with heart failure remains unknown... - Greater maternal weight and the ongoing risk of neural tube defects after folic acid flour fortificationJoel G Ray
Department of Medicine, St Michael s Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada
Obstet Gynecol 105:261-5. 2005..Because overweight women may consume greater quantities of refined wheat flour, we questioned whether their risk of NTD changed after flour fortification... - Cobalamin deficiency in elderly patientsJoel G Ray
CMAJ 172:448-50; author reply 451. 2005 - Increased red cell folate concentrations in women of reproductive age after Canadian folic acid food fortificationJoel G Ray
Epidemiology 13:238-40. 2002 - Alcohol sales and risk of serious assaultJoel G Ray
Department of Medicine, University of Toronto, Toronto, Ontario, Canada
PLoS Med 5:e104. 2008..We assessed the risk of being hospitalized due to assault in association with retail alcohol sales across Ontario... - Hyperhomocysteinemia: no longer a consideration in the management of venous thromboembolismJoel G Ray
Department of Medicine, St Michael s Hospital, University of Toronto, Toronto, Canada
Curr Opin Pulm Med 14:369-73. 2008..To determine whether clinicians should continue to screen for or treat hyperhomocysteinemia among individuals with venous thromboembolism... - Acanthosis nigricans among women with gestational diabetes mellitus and risk of adverse pregnancy outcomesJulie Daitchman
Diabetes Care 31:e30. 2008 - Metabolic syndrome features and risk of neural tube defectsJoel G Ray
Department of Medicine, St, Michael s Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada
BMC Pregnancy Childbirth 7:21. 2007..Whether they, in combination with additional features of MetSyn, alter this risk is not known. We evaluated the risk of NTD in association with maternal features of the MetSyn... - Results of the Recent Immigrant Pregnancy and Perinatal Long-term Evaluation Study (RIPPLES)Joel G Ray
Department of Medicine, St Michael s Hospital, University of Toronto, Toronto, Ont
CMAJ 176:1419-26. 2007..We tested whether the "healthy immigrant effect" extends to the risk of placental dysfunction during the short interval of pregnancy... - Breast size and risk of type 2 diabetes mellitusJoel G Ray
Departments of Medicine, and the Li Ka Shing Knowledge Institute, St Michael s Hospital, University of Toronto, Toronto, Ont
CMAJ 178:289-95. 2008..We sought to evaluate whether a woman's breast size in late adolescence is associated with an increased risk of type 2 diabetes mellitus in adulthood... - Prepregnancy diabetes and risk of placental vascular diseaseTaryn Becker
Division of Endocrinology and Metabolism, University of Toronto, Toronto, Ontario, Canada
Diabetes Care 30:2496-8. 2007 - Maternal ethnicity and risk of neural tube defects: a population-based studyJoel G Ray
Department of Medicine, St Michael s Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario M5B 1WB, Canada
CMAJ 171:343-5. 2004..Maternal body mass and the presence of diabetes mellitus are probable risk factors for neural tube defects (NTDs). The association between maternal ethnicity and the risk of NTDs remains poorly understood, however... - Estimating the prevalence of renal insufficiency in seniors requiring long-term careAmit X Garg
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
Kidney Int 65:649-53. 2004..The objective of this study was to estimate the prevalence of low glomerular filtration rate (GFR) in a large sample of elderly adults living in long-term care facilities, and to compare two commonly used methods for estimating GFR... - Adverse perinatal outcomes associated with homelessness and substance use in pregnancyMerry Little
Department of Obstetrics and Gynecology, St. Michael's Hospital, University of Toronto, Toronto, Ont
CMAJ 173:615-8. 2005..9 (95% CI 1.9-18.5), 16.6 (95% CI 3.5-79.3) and 5.6 (95% CI 1.1-28.7), respectively. INTERPRETATION: Homelessness and maternal substance use may reduce neonatal well-being through prematurity and low birth weight... - Cardiovascular health after maternal placental syndromes (CHAMPS): population-based retrospective cohort studyJoel G Ray
Department of Medicine, St Michael s Hospital, University of Toronto, Toronto, Ontario M5B 1W8, Canada
Lancet 366:1797-803. 2005..Our aim was to assess the risk of premature vascular disease in women who had had a pregnancy affected by maternal placental syndromes... - Prevention of venous thromboembolismWilliam Geerts
Chest 128:3775-6. 2005 - Prophylaxis for the thromboembolic disease--recommendations from the American College of Chest Physicians--are they appropriate for orthopaedic surgery?Clifford W Colwell
J Arthroplasty 21:148-9; author reply 149. 2006 - Metabolic syndrome and the risk of placental dysfunctionJoel G Ray
Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON
J Obstet Gynaecol Can 27:1095-101. 2005..Studies are needed to determine whether modifying a woman's metabolic profile before pregnancy, through modest caloric restriction and increased physical activity, can lower her future risk of PD... - Sale of kava extract in some health food storesEdward Mills
CMAJ 169:1158-9. 2003..Two months after the ban, 17 (57%) of 30 stores continued to sell kava. These findings demonstrate that health food stores may need to be better informed about the sale of restricted natural health products... - Primary and secondary prevention of heart failure with statinsJacob A Udell
University of British Columbia, Department of Medicine, Vancouver Hospital and Health Sciences Centre, 2775 Laurel Street, Vancouver, British Columbia, V5Z 1M9, Canada
Expert Rev Cardiovasc Ther 4:917-26. 2006.... - Trends in obesity in pregnancyJoel G Ray
Epidemiology 18:280-1. 2007 - Use of maternal GHb concentration to estimate the risk of congenital anomalies in the offspring of women with prepregnancy diabetesAndrea Guerin
Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
Diabetes Care 30:1920-5. 2007..We sought to determine the absolute risk of having a congenital anomaly in relation to periconceptional GHb concentration among women with prepregnancy diabetes... - Lipid-lowering therapy and outcomes in heart failureJoel G Ray
Department of Medicine, Divisions of General Internal Medicine and Endocrinology and Metabolism, St Michael s Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada
J Cardiovasc Pharmacol Ther 12:27-35. 2007..More data are needed before statins can be recommended in those with isolated heart failure... - Evidence for suboptimal use of periconceptional folic acid supplements globallyJoel G Ray
Inner City Health Programme, Department of Medicine, St Michael's Hospital, University of Toronto, Ontario, Canada
BJOG 111:399-408. 2004..Consideration should be given to the practical advantages of folic acid fortification of centrally processed foods, such as wheat, corn and rice flour, while further promoting vitamin tablet supplement use and planned pregnancy...