In March I wrote about the link between following a Mediterranean style diet and the risk of having a baby affected by spina bifida. The study (1) that I mentioned found that mothers following a Mediterranean style diet seemed to have a reduced risk of having a baby affected by the condition. Spina bifida is a birth defect, known as a neural tube defect, that occurs when the spinal cord fails to close completely. The research seemed to show that folate (folic acid) and vitamin B12 may be of particular importance to expectant mothers. Folic acid supplementation is now recommended to all women planning to get pregnant and during the early stages of pregnancy since supplementation has been shown to prevent the condition. However, folate is not the only protective nutrient to consider, a healthy diet as a whole is very important for all individuals especially pregnant women, folate is simply one major factor.
Neural tube defects are birth defects that affect the brain and spinal cord. They can lead to a lifelong disability or in some cases death. The two most common ones are spina bifida and anencephaly, a fatal condition in which the brain and skull do not develop normally.
In a recently published study (2) the relationship between vitamin B12 and neural tube defects was investigated. Vitamin B12 works with folate in the body and these vitamins are important for several biochemical reactions as well as with the synthesis and formation of healthy DNA. Vitamin B12 is particularly important for red blood cell and nerve cell formation. The study looked at a group of Irish women since Ireland has a high rate of neural tube defects.
The study involved around 1,200 women (2) who gave blood samples during early pregnancy, these were analysed to determine vitamin B12 levels. Mothers of children affected by a neural tube defect had significantly lower blood levels of vitamin B12 than those women who had children not affected. Women with the lowest levels of vitamin B12, compared with the highest, were on average 2-3 times more likely to be the mother of a child affected by neural tube defect. Women with the very lowest levels of vitamin B12, those who showed clinical deficiency of the vitamin, were five times more likely to have a baby with a neural tube defect than those women with the highest levels of vitamin B12
The authors conclude that deficient or inadequate maternal vitamin B12 status is associated with a significantly increased risk for having a child affected by neural tube defects. The results were independent of the maternal levels of folic acid, showing that B12 was important in it’s own right (2).
Most women are already aware of the importance of folic acid (folate) for the prevention of spinal bifida, the authors of this new study hope that awareness of the importance of vitamin B12 for the further reduction of the risk of neural tube defects also increases among women of childbearing age.
Although the researchers noted that their results needed to be confirmed by other studies among other populations of women they suggest that women of childbearing age ensure they get enough vitamin B12 in order to prevent deficiency or inadequate levels at the start of pregnancy. It is critical that women consider their nutritional status before they become pregnant since the developmental events that are involved with neural tube defects occur in the first four weeks of pregnancy, once a women realises that she has become pregnant it is often after this crucial 4 week timeframe.
Vitamin B12 is found in virtually all meat products, dairy products, eggs, fish, shellfish and fortified breakfast cereals. It can also be found in certain algae and seaweeds. The recommended nutrient intake (RNI) in the UK for adults aged 19-64 is 1.5 micrograms (µg) per day (or 0.0015mg per day).
Women who eat meat, fish or dairy foods regularly should be able to get enough vitamin B12 from their diet. However, because vitamin B12 isn’t found in vegetable foods vegans and vegetarians who do not regularly consume dairy foods might not get enough of this important vitamin. For more information vegans and vegetarians may wish to visit the vegetarian and vegan foundation website and read the fact sheet on vitamin B12. Individuals suffering from intestinal disorders such as inflammatory bowel disease may also have inadequate levels of vitamin B12 since these kinds of conditions often prevent the absorption of sufficient amounts of the vitamin. In such cases it may be wise to visit a doctor to discuss the use of regular vitamin B12 supplements.
Any woman who is planning a pregnancy and who is concerned that she is not eating a consistently healthy diet rich in vegetables, fruits and healthy fats may wish to consider taking a broad-spectrum food-state supplement specifically designed for pregnancy in order to main good levels of all nutrients, this kind of supplement should contain a good level of vitamin B12. An omega 3 fatty acid supplement could also be considered, especially if oily fish and nuts/seeds are not regularly eaten. Before deciding to take a supplement please discuss your thoughts with a GP, nurse or midwife.
(1) Vujkovic M et al. 2009. The maternal Mediterranean dietary pattern is associated with a reduced risk of spina bifida in the offspring. BJOG. 116(3):408-15
(2)Molloy AM et al. 2009. Maternal vitamin B12 status and risk of neural tube defects in a population with high neural tube defect prevalence and no folic Acid fortification.
Pediatrics. 123(3):917-23.
Written by Ani Kowal
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