The levels of vitamın B₁₂, folate and homocysteine in mothers and their babies with neural tube defects

Abstract

The aim of the present study was to determine the serum levels of vitamin B12, folate, and homocysteine (Hcy) in mothers and their babies, and to assess the association between these levels and neural tube defect (NTD). The study group included 92 baby-mother pairs, where the babies had NTD, and the control group included 102 pairs, where the babies had no NTD, from May 2012 to May 2015. Plasma vitamin B12, folate, and Hcy levels of the babies and mothers were measured, and compared with each other. NTD was diagnosed in 2.6% of our babies. The vitamin B12 levels in the mothers and the babies in the study group were determined as 166.2 ± 63.7 pg/mL and 240.3 ± 120.3 pg/mL, and in the control group as 1 9 0 ± 80.2 pg/mL and 299.5 ± 151.4 pg/mL, respectively. There was a significant difference between the two groups in terms of both the mothers' and the babies' vitamin B12 levels (p = 0.024 and p = 0.003, respectively). The plasma folate levels of the mothers in the study group (5.2 ± 3 ng/mL) were significantly lower than control group (6.4 ± 4.3 ng/mL, p = 0.032).The plasma Hcy level of the mothers in the study group (9.3 ± 3.8 μmol/L) was significantly higher than the control group (7 ± 3.8 μmol/L, p < 0.001). High plasma Hcy levels and low plasma folate and vitamin B12 levels are risk factors for NTD. Our results show that the risk for NTD can be decreased by fortification of mothers-to-be, particularly in rural areas with folate and vitamin B12 deficiency, which would lower the plasma Hcy level.

Inhibiting MARSs reduces hyperhomocysteinemia‐associated neural tube and congenital heart defects

“…The high MARS levels enhance sensitivity to changes in homocysteine levels in these developing and proliferating cells. Although hyperhomocysteinemia is associated with many major diseases, it consistently requires a more severe homocysteine elevation (> 150 lM) to induce adult diseases such as neurodegenerative disorders (Kruman et al, 2000;Mattson & Shea, 2003), whereas birth defects are associated with even a very slight Hcy elevation (8-15 lM) (Mills et al, 1995;van der Put et al, 1998;Bakker et al, 2009;Peker et al, 2016). This notion is substantiated by the finding that folate supplementation failed to prevent cardiovascular diseases (Wierzbicki, 2007) or other adult disorders (Brattstrom et al, 1998) and promoted the growth of preneoplastic cells and subclinical cancers (Kim, 2003;Ulrich & Potter, 2007), but prevented birth defects.…”

Association between biomarkers of vitamin B12 status and the risk of neural tube defects

“…Peker, determined the serum levels of vitamin B12 and Hcy in mothers and their babies and assessed the association between these levels and NTD. He found that high plasma Hcy levels and low plasma vitamin B12 levels are risk factors for NTD.…”

Should vitamin B12 status be considered in assessing risk of neural tube defects?

“…Both concluded that maternal B 12 deficiency is an important consideration in relation to NTDs, although it must be said that discrepancies and lack of clarity between the data included in the meta‐analyses and data reported in the original studies indicate that these meta‐analyses were limited in scope. The derived estimates should be interpreted with caution …”

“…The derived estimates should be interpreted with caution. 39,40 Observations from clinical trials From the above studies, it seems reasonable to assume, albeit based on observational blood data (low-grade evidence), that inadequate maternal vitamin B 12 status is a risk factor for having an NTD-affected pregnancy. Two additional anecdotal comments support this assumption.…”