Maternal serum B12 levels and risk for neural tube defects in a Texas-Mexico border population.
OBJECTIVE
Neural tube defects (NTDs) are common birth defects that can be prevented with folate fortification and supplementation. Studies suggest that other nutrients may also be essential to neural tube closure and have a potential role in risk reduction, with vitamin B(12) mentioned most often. We determined the effect of maternal serum B(12) levels, measured postpartum, on the risk of NTDs among a high risk Mexican American population.


METHODS
The case-control study included 157 Mexican American women with NTD-affected pregnancies and 186 Mexican American women with normal pregnancies, who were residents of Texas-Mexico border counties and delivered during 1995 to 2000.


RESULTS
Compared with women in the highest vitamin B(12) quintile, women in the lowest quintile showed a strong risk effect (odds ratio (OR) = 3.0, confidence interval (CI): 1.4, 6.3); while those in the 2nd and 3rd quintiles showed moderate risk effects (OR = 1.6, CI = 0.7, 3.6 and OR = 1.7, CI = 0.8, 3.8, respectively). Adjusting for obesity, vitamin supplements, dietary folate, dietary B(12), red blood cell folate, and other covariates did not materially change these estimates.


CONCLUSIONS
Insufficient levels of serum B(12), which are not normally indicative of a classical vitamin B(12) deficiency nor stem from an inadequate diet, may be an important etiologic factor for NTDs in this population.
Suarez
Lucina
L
Texas Department of Health, Austin 78756, USA. lucina.suarez@tdh.state.tx.us
Hendricks
Kate
K
Felkner
Marilyn
M
Gunter
Elaine
E
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005492:Folic Acid / Q000097:blood; D006801:Humans; D017058:Mexican Americans; D009436:Neural Tube Defects / Q000453:epidemiology*; D049590:Postpartum Period; D011247:Pregnancy; D018570:Risk Assessment; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology; D014805:Vitamin B 12 / Q000097:blood*
D005492:Folic Acid; D014805:Vitamin B 12