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—I appreciate the comments by Dr Czeizel, who provides accurate prevalence data on NTD in Hungary as well as sib-occurrence figures. He also picked out the one instance of the use of the term incidence instead of prevalence (which had been used repeatedly in the article before that time).Unfortunately, the hypothesis of the possible link between folate metabolism and heredity was published after submission of the manuscript, accounting in part for its omission. The relationship of NTD with low levels of maternal serum folic acid was noted in the article.The contributions of Dr Czeizel to the study of NTD are well known and respected. In writing the article for the STATE OF THE ART/REVIEW, I attempted to direct it toward practitioners of medicine and not individuals working in the area scientifically. In doing so, general comments were included that might apply "worldwide" but not to individual
Lemire RJ. Neural Tube Defects-Reply. JAMA. 1988;259(24):3562. doi:10.1001/jama.1988.03720240024028