Maternal serum vitamin B₁₂, folate and homocysteine and the risk of neural tube defects in the offspring in a high-risk area of China

Abstract

Objective: To examine the association between the risk of neural tube defects (NTD) and maternal serum vitamin B 12 , folate and homocysteine in a high-risk area of China. Design: A case-control study was carried out in Luliang mountain area of Shanxi Province. Subjects/setting: A total of eighty-four NTD pregnancies and 110 matched controls were included in the study; their serum vitamin B 12 and folate concentrations were measured by chemiluminescent immunoenzyme assay and total homocysteine concentrations by fluorescent polarisation immunoassay. Results: Serum vitamin B 12 and folate concentrations were lower in NTD-affected pregnant women than in controls (P , 0?01). Serum total homocysteine was higher in the NTD group than in controls at less than 21 weeks of gestation (P , 0?01). Adjusted odds ratios revealed that women with lower vitamin B 12 (adjusted OR54?96; 95 % CI 1?94, 12?67) and folate (adjusted OR53?23; 95 % CI 1?33, 7?85) concentrations had a higher risk of NTD compared to controls. Based on dietary analysis, less consumption of meat, egg or milk, fresh vegetables and fruit intake would increase the risk of NTD. Conclusions: Lower serum concentrations of folate and vitamin B 12 are related to the increased risk of NTD in high-risk populations. Both folate and vitamin B 12 intake insufficiency could contribute to the increased risk of NTD. A dietary supplement, combining folate and vitamin B 12 , might be an effective measure to decrease the NTD incidence in these areas.

Association of sociodemographic and nutritional factors with risk of neural tube defects in the North Indian population: a case–control study

“…The current study suggested an association of NTD risk with low consumption of vegetables, fruits and milk, which is consistent with previous studies (12,13) . However, the present study's finding of a significant association of NTD occurrence among mothers with vegetarian dietary habits provides a clue towards the role of micronutrients which may be low in a vegetarian diet.…”

“…A previous finding also suggested a role of vegetarian dietary habits in the aetiology of NTD among the Hindu community of India (32) . The Mediterranean dietary pattern, characterized by high intakes of fruits, vegetables, vegetable oils, alcohol, fish, legumes and cereals, and low intakes of potatoes and sweets, was found to be correlated with higher levels of serum and red-blood-cell folate, serum vitamin B 12 and lower plasma homocystiene, and subsequently decreased risk for NTD (5,33) . In the present study, some case mothers were not included due to the absence of properly matched control mothers; however, no statistical difference was observed between the general characteristics of cases included and excluded from the study.…”

“…Epidemiological studies have correlated the risk of NTD with low socio-economic status and nutritional intake (3)(4)(5) . Deficiency of folate and vitamin B 12 disrupts the one-carbon metabolic cycle, which leads to the accumulation of homocysteine and in turn may cause NTD through various mechanisms like impaired methylation activity, endothelial dysfunction through oxidative stress, and teratogenic interaction of increased homocysteine with the N-methyl-D-asparate receptor system involved in neuronal development and migration (6) . The breakthrough discovery of lower NTD risk with folate or multivitamin supplementation or food fortification proved to be helpful in reducing the incidence of NTD in many parts of the world (7)(8)(9)(10)(11) .…”

PCMT1 gene polymorphisms, maternal folate metabolism, and neural tube defects: a case–control study in a population with relatively low folate intake

“…Periconceptional folic acid supplementation has been reported to prevent 50-70 % of NTDs (Czeizel and Dudas 1992;De Wals et al 2007). We previously demonstrated that nutrient deficiency is an important independent risk factor for birth defects (Zhang et al 2008a), and lower plasma concentrations of folate and vitamin B12 are related to an increased risk of NTDs in high-risk populations (Zhang et al 2009). Many polymorphisms in folate pathway genes have been investigated and shown to be associated with NTD risk (Zhu et al 2003;van der Linden et al 2006;Boyles et al 2006).…”

Use of folic acid during pregravid preparation and pregnancy

“…Недоста-ток витамина В 12 у беременных увеличивает риск развития врожденных дефектов плода, прежде всего ДНТ [54][55][56], а также пороков сердечно-сосудистой системы [57,58]. Уровень витамина В 6 в верхней половине диапазона нор-мы дает более высокие шансы забеременеть (ОШ -1,4; 95% ДИ: 1,1-1,9) и меньше шансов потерять беремен-ность (ОШ -0,7; 95% ДИ: 0,4-1,1) по сравнению с низ-кой нормальной концентрацией витамина В 6 [59].…”