Skip to main content Accessibility help
×
Home

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

  • Ting Zhang (a1), Ruolei Xin (a1), Xue Gu (a1), Fang Wang (a1), Lijun Pei (a2), Liangming Lin (a1), Gong Chen (a2), Jianxin Wu (a1) and Xiaoying Zheng (a2)...

Abstract

Objective

To examine the association between the risk of neural tube defects (NTD) and maternal serum vitamin B12, 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 B12 and folate concentrations were measured by chemiluminescent immunoenzyme assay and total homocysteine concentrations by fluorescent polarisation immunoassay.

Results

Serum vitamin B12 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 B12 (adjusted OR=4·96; 95 % CI 1·94, 12·67) and folate (adjusted OR=3·23; 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 B12 are related to the increased risk of NTD in high-risk populations. Both folate and vitamin B12 intake insufficiency could contribute to the increased risk of NTD. A dietary supplement, combining folate and vitamin B12, might be an effective measure to decrease the NTD incidence in these areas.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

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

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

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

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

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

Copyright

Corresponding author

*Corresponding author: Email xzheng@pku.edu.cn or phd@pku.edu.cn

References

Hide All
1.Wald, N, Sneddon, J, Densem, J, Frost, C & Stone, R (1991) MRC vitamin study research group. Prevention of neural tube defects: results of the medical research council vitamin study. Lancet 338, 131137.
2.Czeizel, AE & Dudas, I (1992) Prevention of the first occurrence of neural-tube defect by periconceptional vitamin supplementation. N Engl J Med 327, 18321835.
3.Shaw, G, Velie, EM & Schaffer, DM (1997) Is dietary intake of methionine associated with a reduction in risk for neural tube defect-affected pregnancies? Teratology 56, 295299.
4.Wald, NJ, Hackshaw, AD, Stone, R & Sourial, NA (1996) Blood folic acid and vitamin B12 in relation to neural tube defects. Br J Obstet Gynaecol 103, 319324.
5.Groenen, PM, Rooij, IA, Peer, PG, Gooskens, RH, Zielhuis, GA & Steegers-Theunissen, RP (2004) Marginal maternal vitamin B12 status increases the risk of offspring with spina bifida. Am J Obstet Gynecol 191, 1117.
6.Shoob, HD, Sargent, RG, Thompson, SJ, Best, RG, Drane, JW & Tocharoen, A (2001) Dietary methionine is involved in etiology of neural tube defected pregnancies in humans. J Nutr 131, 26532658.
7.Blom, HJ, Shaw, GM, den Heijer, M & Finnell, RH (2006) Neural tube defects and folate: case far from closed. Nat Rev Neurosci 7, 724731.
8.Moore, CA, Li, S, Li, Z, Hong, SX, Gu, HQ, Berry, RJ, Mulinare, J & Erickson, JD (1997) Elevated rates of severe neural tube defects in a high-prevalence area in northern China. Am J Med Genet 73, 113118.
9.Xiao, KZ (1989) The epidemiology of neural tube defects in China. Chin J Med 69, 189191.
10.Li, Z, Ren, A, Zhang, L, Ye, R, Li, S, Zheng, J, Hong, S & Wang, T (2006) Extremely high prevalence of neural tube defects in a 4-county area in Shanxi Province, China. Birth Defects Res A: Clin Mol Teratol 76, 237240.
11.Elwood, JM, Little, J & Elwood, JH (1992) Epidemiology and Control of Neural Tube Defects, pp. 96–145. Oxford: Oxford University Press.
12.Tang, LS & Finnell, RH (2003) Neural and orofacial defects in Folp1 knockout mice. Birth Defects Res A: Clin Mol Teratol 67, 209218.
13.Li, Z, Ren, A, Zhang, L, Guo, Z & Li, Z (2006) A population-based case–control study of risk factors for neural tube defects in four high-prevalence areas of Shanxi province, China. Paediatr Perinat Epidemiol 20, 4353.
14.Gu, X, Lin, L, Zheng, X et al. (2007) High prevalence of NTD in Shanxi Province: a combined epidemiological approach. Birth Defects Res A: Clin Mol Teratol 79, 702707.
15.Minet, JC, Bissé, E, Aebischer, CP, Beil, A, Wieland, H & Lütschg, J (2000) Assessment of vitamin B-12, folate, and vitamin B-6 status and relation to sulfur amino acid metabolism in neonates. Am J Clin Nutr 72, 751757.
16.Wong, C-K, Hammett, CJK, The, R et al. (2004) Lack of association between baseline plasma homocysteine concentrations and restenosis rates after a first elective percutaneous coronary intervention without stenting. Heart 90, 12991302.
17.Steen, MT, Boddie, AM, Fisher, AJ, Macmahon, W, Saxe, D, Sullivan, KM, Dembure, PP & Elsas, LJ (1998) Neural tube defects are associated with low concentrations of cobalamin (vitamin B12) in amniotic fluid. Prenat Diagn 18, 545555.
18.Afman, LA, Van-Der-Put, NMJ, Thoma, CMG, Trijbels, JMF & Blom, HJ (2001) Reduced vitamin B12 binding by transcobalamin II increased the risk of neural tube defects. Q J Med 94, 159166.
19.Kirke, PN, Molloy, AM, Daly, LE, Burke, H, Weir, DG & Scott, JM (1993) Maternal plasma folate and vitamin B12 are independent risk factors for neural tube defects. Q J Med 86, 703708.
20.Ray, JG & Blom, HJ (2003) Vitamin B12 insufficiency and the risk of fetal neural tube defects. Q J Med 96, 289295.
21.Mills, JL, McPartlin, JM, Kirke, PN, Lee, YJ, Conley, MR, Weir, DG & Scott, JM (1995) Homocysteine metabolism in pregnancies complicated by neural-tube defects. Lancet 345, 149151.
22.Suarez, L, Hendricks, K, Felkner, M & Gunter, E (2003) Maternal serum B12 levels and risk for neural tube defects in a Texas–Mexico border population. Ann Epidemiol 13, 8188.
23.Finnell, RH, Gould, A & Spiegelstein, O (2003) Pathobiology and genetics of neural tube defects. Epilepsia 44, Suppl. 3, 1423.
24.Patrick, JS (2004) Physiology of folate and vitamin B12 in health and disease. Nutr Rev 62, S3S12.
25.Ortigues-Marty, I, Micol, D, Prache, S & Dozias D Girard, CL (2005) Nutritional value of meat: the influence of nutrition and physical activity on vitamin B12 concentrations in ruminant tissues. Reprod Nutr Dev 45, 453467.
26.Stover, PJ (2004) Physiology of folate and vitamin B12 in health and disease. Nutr Rev 62, 312.
27.Lindblad, B, Zaman, S, Malik, A, Martin, H, Ekström, AM, Amu, S, Holmgren, A & Norman, M (2005) Folate, vitamin B12 and homocysteine levels in South Asian women with growth-retarded fetuses. Acta Obstet Gynecol Scand 84, 10551061.
28.Bondevik, GT, Schneede, J, Refsum, H, Lie, RT, Ulstein, M & Kvåle, G (2001) Homocysteine and methylmallonic acid levels in pregnant Nepali women. Should cobalamin supplementation be considered? Eur J Clin Nutr 55, 856864.
29.Park, H, Kim, YJ, Ha, EH, Kim, KN & Chang, N (2004) The risk of folate and vitamin B12 deficiencies associated with hyperhomocysteinemia among pregnant women. Am J Perinatol 21, 469475.
30.Grainger, RB, O’Dell, BL & Hogan, AG (1954) Congenital malformations as related to deficiencies of riboflavin and vitamin B12, source of protein, calcium to phosphorus ratio and skeletal phosphorus metabolism. J Nutr 54, 3348.

Keywords

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

  • Ting Zhang (a1), Ruolei Xin (a1), Xue Gu (a1), Fang Wang (a1), Lijun Pei (a2), Liangming Lin (a1), Gong Chen (a2), Jianxin Wu (a1) and Xiaoying Zheng (a2)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed