Neural tube defects

Overview

Vitamin B9 (Folate) (WA 68; medium effect size, high evidence, high trust) has high-strength evidence for preventing neural tube defects. Research supports folic acid supplementation to reduce these birth defects, with guideline-recommended daily doses for women who can become pregnant and higher doses for those with prior affected pregnancies.

Methionine (WA 40; low effect size, evidence, and trust) has medium-strength observational evidence suggesting higher dietary methionine during pregnancy may be associated with lower neural tube defect risk compared with lower intake.

Folate stands out as the best-supported supplement in this condition. The heatmap and evidence reviews below summarize individual studies.

Effect graph

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Relevant supplements

Relevant supplements sorted by DEX Score.


Vitamin B9 (Folate)	★★★★★	Medium
Methionine	★★★★★	Low

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Studies

Find individual evidence reviews for supplements sorted by DEX Score.

2 supplements for and rated at least stars. All purchase bands. No minimum star filter.

Vitamin B9 (Folate)View supplement →

Consider purchase★★★★★

How we scored this

Effect SizeMediumEvidenceHighTrustHigh

Evidence Review

Taking folic acid by mouth helps prevent serious birth defects of the brain and spine called neural tube defects.
Health guidelines recommend that all women who can become pregnant take 400 micrograms of folic acid daily from fortified foods or supplements, and pregnant women take 600 micrograms daily.
Women who had a child with these birth defects are advised to take a higher dose of 4000 micrograms daily starting before pregnancy and continuing after.
Research shows folic acid can reduce the chances of these birth defects by 40 to 70 percent in first-time pregnancies and by up to 87 percent in later pregnancies.
Many countries add folic acid to cereals to help lower birth defect rates in the population.

Browse 7 studies5 meta-analyses

GuideFolic Acid Supplementation for the Prevention of Neural Tube Defects: US Preventive Services Task Force Recommendation Statement2017

A study in women found that in 2009, the USPSTF reviewed the effectiveness of folic acid supplementation in women of childbearing age for the prevention of neural tube defects in infants.

Dose: 0.8 mg/day
Population: Women

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MetaThe effect of folic acid, protein energy and multiple micronutrient supplements in pregnancy on stillbirths2011

A meta-analysis of 18 studies found that pooled results from 13 studies evaluating role of multiple micronutrients supplementation during pregnancy showed no significant effect in reducing stillbirths [RR = 0.98; 95% CI: 0.88 - 1.10] or perinatal mortality [RR = 1.07; 95% CI: 0.92 - 1.25; random model].

Effect: Benefit
Population: Pregnant women

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MetaEffects and safety of periconceptional folate supplementation for preventing birth defects2010n=6,105

A meta-analysis of 6105 participants found that the results are consistent in showing a protective effect of daily folic acid supplementation (alone or in combination with other vitamins and minerals) in preventing NTDs compared with no interventions/placebo or vitamins and minerals without folic acid (risk ratio (RR).

Effect: Benefit
Population: Women
Participants: 6,105

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MetaFolic acid to reduce neonatal mortality from neural tube disorders2010

A meta-analysis found that for NTD primary prevention through folic acid supplementation, combining one RCT with three cohort studies which adjusted for confounding, suggested a reduction of 62% (95% CI: 49-71).

Effect: Benefit
Population: Women

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MetaFolic acid, methylation and neural tube closure in humans2009

A meta-analysis found that fourth, the questions whether folate receptor autoantibodies or hampered methylation are mechanisms underlying NTDs are briefly discussed.

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MetaFolic acid supplementation and neural tube defect recurrence prevention2007

A meta-analysis found that 4 mg/day observational studies report reductions in recurrence risk of 85% to 100% among women taking folic acid prior to subsequent pregnancies.

Effect: Benefit
Dose: 4 mg/day
Population: Women

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Folate status during pregnancy in women is improved by long-term high vegetable intake compared with the average western diet2001n=43

A prospective study of 109 pregnant women found that long-term high vegetable intake (8+ years) raised plasma and red blood cell folate throughout pregnancy and lowered folate deficiency risk versus an average Western diet.

Effect: Benefit
Population: Women
Participants: 43

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MethionineView supplement →

Reconsider purchase★★★★★

How we scored this

Effect SizeLowEvidenceLowTrustLow

Evidence Review

Eating more foods that contain methionine during pregnancy may help reduce the chance of having a baby with a neural tube defect.
Research suggests that women who consume more methionine have a lower risk compared to those who consume less.

Browse 2 studies

ObservationalDietary methionine is involved in the etiology of neural tube defect-affected pregnancies in humans2001

A case-control study of 170 neural tube defect pregnancies found maternal dietary methionine intake above 1,580 mg/day was associated with 30–55% lower NTD risk.

Effect: Benefit
Dose: 580 mg/day
Population: Women

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ObservationalIs dietary intake of methionine associated with a reduction in risk for neural tube defect-affected pregnancies?1997

A California case-control study found maternal dietary methionine intake above 1,342 mg/day before conception was associated with about 30–40% lower risk of NTD-affected pregnancies.

Effect: Benefit
Dose: 341.86 mg/day
Population: Women

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Evidence visualised

Same ratings as above, aggregated so you can see coverage and imbalance.

Purchase-guidance distribution

How many supplements fall in each purchase band

Effect-size distribution

How large the reported benefits tend to be

Study distribution across 2 supplements for neural tube defects (9 studies total).
Supplement	DEX	Studies	Meta-analyses	Share
Vitamin B9 (Folate)	★★★★★68%	7	5	78%
Methionine	★★★★★40%	2	0	22%

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Overview

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Studies

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