Neural tube defects and maternal intake of micronutrients related to one-carbon metabolism or antioxidant activity

Birth Defects Res A Clin Mol Teratol. 2012 Nov;94(11):864-74. doi: 10.1002/bdra.23068. Epub 2012 Aug 29.


Background: Maternal nutritional status has been evaluated to clarify its role in development of neural tube defects (NTDs). Maternal folate intake during pregnancy has been closely evaluated for its association with NTDs. The study objective was to examine associations between NTDs and other dietary periconceptional micronutrient intake, particularly nutrients involved in one-carbon metabolism or antioxidant activity.

Methods: Using data from the National Birth Defects Prevention Study, 1997-2005, logistic regression models were used to estimate the relative risk of NTDs based on maternal micronutrient intake.

Results: Results were stratified according to folic acid supplement use, race/ethnicity, and maternal body mass index. Analyses included 954 cases (300 with anencephaly, 654 with spina bifida) and 6268 controls. Higher intakes of folate, thiamin, betaine, iron, and vitamin A were associated with decreased risk of anencephaly among some ethnic and clinical groups. In some groups, higher intakes of thiamin, riboflavin, vitamin B(6) , vitamin C, vitamin E, niacin, and retinol were associated with decreased risk of spina bifida.

Conclusion: In addition to folic acid, other micronutrients, including thiamin, betaine, riboflavin, vitamin B(6) , vitamin C, vitamin E, niacin, iron, retinol, and vitamin A, may decrease the risk of NTD occurrence. Birth Defects Research (Part A) 2012. © 2012 Wiley Periodicals, Inc.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • African Continental Ancestry Group
  • Antioxidants / administration & dosage*
  • Antioxidants / metabolism
  • Body Mass Index
  • Carbon / metabolism*
  • Case-Control Studies
  • Dietary Supplements
  • European Continental Ancestry Group
  • Female
  • Folic Acid / administration & dosage*
  • Folic Acid / metabolism
  • Health Surveys
  • Hispanic Americans
  • Humans
  • Logistic Models
  • Male
  • Maternal Nutritional Physiological Phenomena
  • Micronutrients / administration & dosage*
  • Micronutrients / metabolism
  • Neural Tube Defects / diagnosis
  • Neural Tube Defects / epidemiology*
  • Neural Tube Defects / ethnology
  • Neural Tube Defects / metabolism*
  • Pregnancy
  • Risk Factors
  • United States / epidemiology
  • Vitamins / administration & dosage*
  • Vitamins / metabolism


  • Antioxidants
  • Micronutrients
  • Vitamins
  • Carbon
  • Folic Acid