title: Association of maternal homocysteine and vitamins status with the risk of neural tube defects in Tunisia: A case-control study.
abstract: BACKGROUND
  This study was conducted to determine whether low folate and vitamin B12 levels, as well as high homocysteine levels in pregnant women are associated with neural tube defects (NTDs) in Tunisia.
  
  
  METHODS
  A total of 75 NTDs pregnancies and 75 matched controls were included in the study. Their vitamin B12, folate, and red blood cell folate concentrations were measured using a radio-immunoassay kit and total homocysteine concentrations were determined using a fluorescent polarization immunoassay.
  
  
  RESULTS
  Vitamin B12 and folate concentrations were lower in NTD-affected pregnant women than in controls (respectively, p = 0.009 and p < 0.001). Total homocysteine concentration was significantly higher in the NTDs group than in controls (p = 0.008). In the case group, the folate levels were positively related with vitamin B12 levels (r = 0.54; p < 0.001) and negatively correlated with total homocysteine levels (r = -0.19; p = 0.04). Besides, red blood cell folate levels were positively correlated with folate levels (r = 0.24; p = 0.02) and negatively correlated with total homocysteine levels (r = -0.37; p = 0.001).
  
  
  CONCLUSIONS
  Lower concentrations of folate and vitamin B12 are related to the increased risk of NTDs. Both folate and vitamin B12 intake insufficiency could contribute to the increased risk of NTDs. A dietary supplement, combining folate and vitamin B12, might be an effective measure to decrease the NTDs incidence in Tunisia.
authors.affiliation: Faculté des Sciences de Bizerte, Université de Carthage, 7021 Zarzouna, Bizerte, Tunisia.|UR 06/ SP14 Troubles du développement embryo-fœtal et placentaire, Service d'embryo-fœtopathologie, Centre de Maternité et de Néonatologie La Rabta et de la Faculté de Médecine de Tunis, Université El Manar II, 1007 Tunis, Tunisia.
authors.forename: Kaouther
authors.initials: K
authors.lastname: Nasri
authors.affiliation: UR 05/08-08, Département de biochimie, Hôpital la Rabta et de la Faculté de Médecine de Tunis, Université El Manar II, 1007 Tunis, Tunisia.
authors.forename: Mohamed Kacem
authors.initials: MK
authors.lastname: Ben Fradj
authors.affiliation: Laboratoire de Biologie clinique, Institut National Mongi Ben Hmida de Neurologie, 1007 Tunis, Tunisia.
authors.forename: Asma
authors.initials: A
authors.lastname: Touati
authors.affiliation: Faculté des Sciences de Bizerte, Université de Carthage, 7021 Zarzouna, Bizerte, Tunisia.|UR 06/ SP14 Troubles du développement embryo-fœtal et placentaire, Service d'embryo-fœtopathologie, Centre de Maternité et de Néonatologie La Rabta et de la Faculté de Médecine de Tunis, Université El Manar II, 1007 Tunis, Tunisia.
authors.forename: Mariem
authors.initials: M
authors.lastname: Aloui
authors.affiliation: UR 06/ SP14 Troubles du développement embryo-fœtal et placentaire, Service d'embryo-fœtopathologie, Centre de Maternité et de Néonatologie La Rabta et de la Faculté de Médecine de Tunis, Université El Manar II, 1007 Tunis, Tunisia.
authors.forename: Nadia
authors.initials: N
authors.lastname: Ben Jemaa
authors.affiliation: UR 06/ SP14 Troubles du développement embryo-fœtal et placentaire, Service d'embryo-fœtopathologie, Centre de Maternité et de Néonatologie La Rabta et de la Faculté de Médecine de Tunis, Université El Manar II, 1007 Tunis, Tunisia.
authors.forename: Aida
authors.initials: A
authors.lastname: Masmoudi
authors.affiliation: 01/UR/08-07 Laboratoire d'histologie, embryologie et biologie cellulaire de la Faculté de Médecine de Tunis, Université El Manar II, 1007 Tunis, Tunisia.
authors.forename: Michèle Véronique
authors.initials: MV
authors.lastname: Elmay
authors.affiliation: Laboratoire de Biologie clinique, Institut National Mongi Ben Hmida de Neurologie, 1007 Tunis, Tunisia.
authors.forename: Souhail
authors.initials: S
authors.lastname: Omar
authors.affiliation: UR 05/08-08, Département de biochimie, Hôpital la Rabta et de la Faculté de Médecine de Tunis, Université El Manar II, 1007 Tunis, Tunisia.
authors.forename: Moncef
authors.initials: M
authors.lastname: Feki
authors.affiliation: UR 05/08-08, Département de biochimie, Hôpital la Rabta et de la Faculté de Médecine de Tunis, Université El Manar II, 1007 Tunis, Tunisia.
authors.forename: Naziha
authors.initials: N
authors.lastname: Kaabechi
authors.affiliation: Laboratoire de génétique, immunologie et pathologie humaine, faculté des sciences de Tunis, Université El Manar II, 2092 Tunis, Tunisia.
authors.forename: Raja
authors.initials: R
authors.lastname: Marrakchi
authors.affiliation: UR 06/ SP14 Troubles du développement embryo-fœtal et placentaire, Service d'embryo-fœtopathologie, Centre de Maternité et de Néonatologie La Rabta et de la Faculté de Médecine de Tunis, Université El Manar II, 1007 Tunis, Tunisia.
authors.forename: Soumeya Siala
authors.initials: SS
authors.lastname: Gaigi
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D016231:Fluorescence Polarization Immunoassay; D005492:Folic Acid / Q000097:blood; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D009436:Neural Tube Defects / Q000453:epidemiology*; D011247:Pregnancy; D011863:Radioimmunoassay; D012307:Risk Factors; D014416:Tunisia / Q000453:epidemiology; D014815:Vitamins / Q000097:blood*
chemical_list: D014815:Vitamins; D006710:Homocysteine; D005492:Folic Acid
keywords: folate; homocysteine; neural tube defects; vitamin B12