title: Neural tube defects, micronutrient deficiencies, and Helicobacter pylori: a new hypothesis.
abstract: BACKGROUND
  Previous findings for the Texas Neural Tube Defects Project suggested that while maternal access to nutrients is adequate, bioavailability of nutrients to the fetus is compromised in NTD-affected pregnancies. Helicobacter pylori could cause nutrient loss to the fetus. Folate, B12, and ferritin are depleted in H. pylori infection; these same deficiencies are related to NTD risk.
  
  
  METHODS
  Using H. pylori IgG ELISA Test System, we tested for H. pylori serum antibodies in participants in the population-based case-control study component of the Texas Neural Tube Defect Project conducted along the Texas-Mexico border. Case-women had pregnancies affected by NTD (anencephalus, spina bifida, encephalocele) and resided and delivered in one of the 14 Texas-Mexico border counties from 1995 through 2000. Control-women were study area residents delivering normal live births during the same period.
  
  
  RESULTS
  Of 225 case- and 378 control-women, 103 cases and 156 controls provided questionnaire and H. pylori antibody data. H. pylori seropositivity was modestly associated with NTD-affected pregnancies (OR 1.4; 95% CI: 0.8-2.4). ORs of 2.0 or greater were seen in women younger than age 25 and with less than 7 years education.
  
  
  CONCLUSIONS
  Our findings intimate that H. pylori could play a role in NTD causation in certain populations. While results did not provide compelling support for this proposal, subgroup findings prompt us to advocate an evaluation of this hypothesis in developing nations among populations with higher prevalence of H. pylori, marginal nutrient intake, and young childbearing age.
authors.affiliation: Texas Department of State Health Services, Austin, Texas 78756, USA. marilyn.felkner@dshs.state.tx.us
authors.forename: Marilyn
authors.initials: M
authors.lastname: Felkner
authors.forename: Lucina
authors.initials: L
authors.lastname: Suarez
authors.forename: Beata
authors.initials: B
authors.lastname: Liszka
authors.forename: Jean D
authors.initials: JD
authors.lastname: Brender
authors.forename: Mark
authors.initials: M
authors.lastname: Canfield
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005293:Ferritins / Q000097:blood; D005492:Folic Acid / Q000097:blood; D016481:Helicobacter Infections / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification* / Q000472:pathogenicity; D006801:Humans; D044342:Malnutrition / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D018977:Micronutrients / Q000172:deficiency*; D009436:Neural Tube Defects / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013781:Texas / Q000453:epidemiology; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D018977:Micronutrients; D005293:Ferritins; D005492:Folic Acid; D014805:Vitamin B 12