• dietary periconceptional micronutrients;
  • maternal nutrition;
  • National Birth Defects Prevention Study;
  • neural tube defects;
  • one-carbon metabolism



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.


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 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 B6, vitamin C, vitamin E, niacin, and retinol were associated with decreased risk of spina bifida.


In addition to folic acid, other micronutrients, including thiamin, betaine, riboflavin, vitamin B6, 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.