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Vitamin B-12 and neural tube defects: the Canadian experience.
Am J Clin Nutr. 2009 Feb; 89(2):697S-701S.AJ

Abstract

Although early epidemiologic studies showed a protective effect of adequate maternal folic acid (FA) status against neural tube defects (NTDs), the role of adequate vitamin B-12 nutrition in the putative reduction of NTD frequency has remained uncertain. Evaluating vitamin B-12 status was complicated by the need to control for altered FA status after fortification in Canada. More recent studies have made use of better biomarkers of vitamin B-12 status, including methylmalonic acid and holotranscobalamin (holoTC). HoloTC provides a useful measure of vitamin B-12 status because it represents the bioavailable fraction of circulating vitamin B-12. By assessing bioavailable vitamin B-12 status in a large Canadian cohort accrued before and after FA fortification, we found a 3-fold increase in the risk of NTDs in mothers who had vitamin B-12 status in the lower quartile, regardless of FA fortification. Our work suggests that vitamin B-12 fortification, analogous to the FA fortification program, may reduce NTDs more than FA fortification alone. A multicenter randomized controlled trial comparing periconceptional vitamin B-12 in combination with FA against FA alone is warranted.

Authors+Show Affiliations

Department of Laboratory Medicine and Pathobiology, Banting Institute, University of Toronto, Toronto, ON, Canada.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

19116334

Citation

Thompson, Miles D., et al. "Vitamin B-12 and Neural Tube Defects: the Canadian Experience." The American Journal of Clinical Nutrition, vol. 89, no. 2, 2009, 697S-701S.
Thompson MD, Cole DE, Ray JG. Vitamin B-12 and neural tube defects: the Canadian experience. Am J Clin Nutr. 2009;89(2):697S-701S.
Thompson, M. D., Cole, D. E., & Ray, J. G. (2009). Vitamin B-12 and neural tube defects: the Canadian experience. The American Journal of Clinical Nutrition, 89(2), 697S-701S. https://doi.org/10.3945/ajcn.2008.26947B
Thompson MD, Cole DE, Ray JG. Vitamin B-12 and Neural Tube Defects: the Canadian Experience. Am J Clin Nutr. 2009;89(2):697S-701S. PubMed PMID: 19116334.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin B-12 and neural tube defects: the Canadian experience. AU - Thompson,Miles D, AU - Cole,David E C, AU - Ray,Joel G, Y1 - 2008/12/30/ PY - 2009/1/1/entrez PY - 2009/1/1/pubmed PY - 2009/2/12/medline SP - 697S EP - 701S JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 89 IS - 2 N2 - Although early epidemiologic studies showed a protective effect of adequate maternal folic acid (FA) status against neural tube defects (NTDs), the role of adequate vitamin B-12 nutrition in the putative reduction of NTD frequency has remained uncertain. Evaluating vitamin B-12 status was complicated by the need to control for altered FA status after fortification in Canada. More recent studies have made use of better biomarkers of vitamin B-12 status, including methylmalonic acid and holotranscobalamin (holoTC). HoloTC provides a useful measure of vitamin B-12 status because it represents the bioavailable fraction of circulating vitamin B-12. By assessing bioavailable vitamin B-12 status in a large Canadian cohort accrued before and after FA fortification, we found a 3-fold increase in the risk of NTDs in mothers who had vitamin B-12 status in the lower quartile, regardless of FA fortification. Our work suggests that vitamin B-12 fortification, analogous to the FA fortification program, may reduce NTDs more than FA fortification alone. A multicenter randomized controlled trial comparing periconceptional vitamin B-12 in combination with FA against FA alone is warranted. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/19116334/Vitamin_B_12_and_neural_tube_defects:_the_Canadian_experience_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.2008.26947B DB - PRIME DP - Unbound Medicine ER -