Research Article
Volume 11 Issue 8 - 2022
Association of Neural Tube Defects with Maternal and Neonatal Serum Vitamin B12 Level in Bangladesh: A Multicenter Case Control Study
Fakhrul Amin Badal1*, Abu Faisal Mohammad Pervez2, Mohammod Shahidullah3, Md Abdul Mannan4, Sanjoy Kumar Dey5, Mohammad Kamrul Hasan Sabuj6 and Ferdous Jahan Binte Rashid7
1Residential Physician (Pediatrics), Sheikh Hasina Medical College and Hospital, Tangail, Bangladesh
2Assistant Professor, Department of Neonatology, Bangabandhu Sheikh Mujib Medical College, Faridpur, Bangladesh
3Professor, Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
4Professor of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
5Professor, Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
6Associate Professor, Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
7Medical Officer (Gynae and Obs), Institute of Child and Mother Health, Dhaka, Bangladesh
*Corresponding Author: Fakhrul Amin Badal, Residential Physician (Pediatrics), Sheikh Hasina Medical College and Hospital, Tangail, Bangladesh.
Received: July 04, 2022; Published: July 26, 2022


Background: Neural tube defects (NTDs), a congenital deformity of the central nervous system attributed to multifactorial etiology including nutritional factors e.g. folic acid deficiency. Some studies suggested deficiency of vitamin B12 may be another factor behind NTDs due to its intimate metabolic pathway with folic acid. This study aimed to identify the association of NTDs with maternal and neonatal serum vitamin B12 level.

Methods: This case-control study was conducted from January 2014 to June 2015 in three tertiary level hospitals at Dhaka, Bangladesh. 32 cases (neonate with NTDs-mother pair) were selected from Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital (18), Dhaka Medical College Hospital (8) and Sir Salimullah Medical College and Mitford hospital (6). 40 age and sex matched controls were selected from BSMMU. A baseline assessment of the mothers on age, parity, education, residence, antenatal checkup, method of delivery and socio-economic status was taken. Vitamin B12 was estimated from the venous blood sample of the mother and newborn within 7 days after delivery. We considered < 200 pg/ml of vitamin B12 as ‘deficiency’, 200 - 300 pg/ml as ‘marginal deficiency’ and > 300 pg/ml as ‘normal’. Quantitative data were expressed as mean ± SD and qualitative data were expressed as proportion. Chi-square test and student’s unpaired t-test was used for comparison of categorical and continuous variables respectively. Pearson correlation was used to determine the correlation between continuous variables.

Result: Mothers with low socio-economic status (p = 0.004) and irregular antenatal checkup (p = 0.029) were significantly higher among the cases. Serum vitamin B12 level of mother (p < 0.01) and newborn (p < 0.01) were significantly lower among the cases. Vitamin B12 deficient newborn were significantly higher among the cases (50% vs. 25%). Maternal and neonatal serum vitamin B12 levels were positively correlated with both case (Pearson R = 0.517) and control (Pearson R = 0.627) groups.

Conclusion: This study finding suggests that both maternal and neonatal low serum vitamin B12 level is associated with NTDs. Vitamin B12 supplementation along with folic acid may be considered for to-be-mothers to prevent NTDs.

Keywords: Bangladesh; Neural Tube Defects; Newborn; Tertiary Care Centers; Vitamin B12


  1. Greene NDE and Copp AJ. “Neural tube defects”. Annual Review of Neuroscience 37 (2014): 221-242.
  2. Zaganjor I., et al. “Describing the prevalence of neural tube defects worldwide: A systematic literature review”. PLoS ONE4 (2016): e0151586.
  3. Wang M., et al. “Update on the Role of the Non-Canonical Wnt/Planar Cell Polarity Pathway in Neural Tube Defects”. Cells10 (2019): 1198.
  4. Kancherla V., et al. “Prenatal folic acid use associated with decreased risk of myelomeningocele: A case-control study offers further support for folic acid fortification in Bangladesh”. PLOS ONE11 (2017): e0188726.
  5. Zhang T., et al. “Maternal serum vitamin B12, folate and homocysteine and the risk of neural tube defects in the offspring in a high-risk area of China”. Public Health Nutrition5 (2009): 680-686.
  6. Peker E., et al. “The levels of vitamın B12, folate and homocysteine in mothers and their babies with neural tube defects”. Journal of Maternal-Fetal and Neonatal Medicine18 (2016): 2944-2948.
  7. Molloy AM., et al. “Maternal vitamin B12 status and risk of neural tube defects in a population with high neural tube defect prevalence and no folic acid fortification”. Pediatrics3 (2009): 917-923.
  8. Molloy AM., et al. “Effects of folate and vitamin B12 deficiencies during pregnancy on fetal, infant, and child development”. Food and Nutrition Bulletin2 (2008): 101-111.
  9. Finkelstein JL., et al. “Vitamin B 12 status in pregnant adolescents and their infants”. Nutrients2 (2019): 397.
  10. Riaz M., et al. “Maternal Nutrition during Early Pregnancy and Cardiometabolic Status of Neonates at Birth”. Journal of Diabetes Research (2018): 7382946.
  11. Christianson A., et al. “March of Dimes global report on birth defects: the hidden toll of dying and disabled children”. March of Dimes Birth Defects Foundation 106 (2006).
  12. Yetim A., et al. “Measurement of serum vitamin B12-related metabolites in newborns: implications for new cutoff values to detect B12 deficiency”. Journal of Maternal-Fetal and Neonatal Medicine8 (2019): 1260-1268.
  13. Darnton-Hill I. “Public Health Aspects in the Prevention and Control of Vitamin Deficiencies”. Current Developments in Nutrition9 (2019): 075.
  14. Darnton-Hill I and Mkparu UC. “Micronutrients in pregnancy in low- and middle-income countries”. Nutrients3 (2015): 1744-1768.
  15. Froese DS., et al. “Vitamin B12, folate, and the methionine remethylation cycle-biochemistry, pathways, and regulation”. Journal of Inherited Metabolic Disease4 (2019): 673-685.
  16. Molloy AM. “Should vitamin B12 status be considered in assessing risk of neural tubedefects?” Annals of the New York Academy of Sciences1 (2018): 109-125.
  17. Finkelstein JL., et al. “Vitamin B-12 and Perinatal Health”. Advances in Nutrition5 (2015): 552-563.
  18. Villamor E., et al. “Vitamin B-12 status is associated with socioeconomic level and adherence to an animal food dietary pattern in Colombian school children”. Journal of Nutrition7 (2008): 1391-1398.
  19. Obeid R., et al. “Vitamin B12 intake from animal foods, biomarkers, and health aspects”. Frontiers in Nutrition (2019): 6.
  20. Sarmast AH., et al. “A single center study of epidemiology of neural tube defects”. Journal of Neurosciences in Rural Practice3 (2016): 462-465.
  21. Laharwal M., et al. “Epidemiology of the neural tube defects in Kashmir Valley”. Journal of Pediatric Neurosciences3 (2016): 213-218.
Citation: Fakhrul Amin Badal., et al. “Association of Neural Tube Defects with Maternal and Neonatal Serum Vitamin B12 Level in Bangladesh: A Multicenter Case Control Study”. EC Paediatrics 11.8 (2022): 10-16.

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