A study examining 806 women who had babies with birth defects between 1997 and 2006, and 849 women who had healthy babies, found that smog in the San Joaquin Valley area of California was linked to two types of neural tube defects: spina bifida (a condition involving, among other manifestations, certain malformations of the spinal column), and anencephaly (the underdevelopment or absence of part or all of the brain, which if not fatal usually results in profound impairment).