ArticleAmerican journal of epidemiology2019
One-Carbon Cofactor Intake and Risk of Neural Tube Defects Among Women Who Meet Folic Acid Recommendations: A Multicenter Case-Control Study.
Article in American journal of epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Beyond Folate: The Emerging Role of Maternal Vitamin B12 in Neural Tube Development.Nutrients · 2025Pooled it
- Pooled it
- Association between Maternal Choline, Fetal Brain Development, and Child Neurocognition: Systematic Review and Meta-Analysis of Human Studies.Advances in nutrition (Bethesda, Md.) · 2022Pooled it
- Trial
- Choline status and related health outcomes in humans: A scoping review.Nutrition and health · 2026Article
- Choline and Its Companions: Inter-Related Roles of Choline and B Vitamins in Fetal Development and Offspring Health.Nutrients · 2026Review
- Maternal choline supplementation in neurodevelopmental disorders: mechanistic insights from animal models and future directions.Nutritional neuroscience · 2025Review
- Plasma trimethylamine N-oxide metabolites in the second trimester predict the risk of hypertensive disorders of pregnancy: a nested case-control study.Hypertension research : official journal of the Japanese Society of Hypertension · 2024Article
- Fetal spina bifida associates with dysregulation in nutrient-sensitive placental gene networks: Findings from a matched case-control study.Clinical and translational science · 2024Article
- Periconceptional intakes of methyl donors and other micronutrients involved in one-carbon metabolism may further reduce the risk of neural tube defects in offspring: a United States population-based case-control study of women meeting the folic acid recommendations.The American journal of clinical nutrition · 2023Article
- Neural tube defects: a review of global prevalence, causes, and primary prevention.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023Review
- Nutritional Assessment of the Symptomatic Patient on a Plant-Based Diet: Seven Key Questions.Nutrients · 2023Review
- Vitamins and minerals, education, and self-care need during preconception to 1000 days of life in Southeast Asia: An expert panel opinion.SAGE open medicine · 2023Review
- Choline - a scoping review for Nordic Nutrition Recommendations 2023.Food & nutrition research · 2023Article
- Association and Interaction Effect ofNutrients · 2022Article
- Association between Folic Acid Supplementation and Hypertensive Disorder Complicating Pregnancy in Jiangsu Province: A Cross-Sectional Study.Evidence-based complementary and alternative medicine : eCAM · 2022Article
- Review
- Maternal folic acid and multivitamin supplementation: International clinical evidence with considerations for the prevention of folate-sensitive birth defects.Preventive medicine reports · 2021Review
- Article
- Short interpregnancy intervals and risks for birth defects: support for the nutritional depletion hypothesis.The American journal of clinical nutrition · 2021Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
We aimed to investigate associations between individual and concurrent (≥2) intakes of one-carbon cofactors vitamins B6 and B12, choline, betaine, and methionine and neural tube defect (NTD) outcomes among mothers meeting the folic acid recommendations. In the Slone Birth Defects Study (case-control design; North America, 1998-2015), mothers of 164 NTD cases and 2,831 nonmalformed controls completed food frequency questionnaires and structured interviews. Estimated intakes of one-carbon cofactors were dichotomized (high vs. low) for all except betaine (low or middle vs. high). We used logistic regression models to estimate odds ratios and 95% confidence intervals adjusted for center, age, and race. The analysis was restricted to mothers with estimated daily total folate intake of ≥400 μg during periconception. Fewer cases, compared with controls, had high intakes for each one-carbon cofactor except betaine, where the starkest contrast occurred in the middle group. Women with concurrent high intakes of B6, B12, choline, and methionine and moderate intake of betaine had approximately half the risk of an NTD-affected pregnancy (odds ratio = 0.49, 95% confidence interval: 0.23, 1.08). These findings suggest that, in the presence of folic acid, one-carbon cofactors-notably when consumed together-might reduce NTD risk. Additional research should inform any changes to clinical recommendations.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.