Maternal Folic Acid Supplementation and Neural Tube Defects in Northeast Iran: Insights for Developing Countries.

Background: Neural tube defects (NTDs) are among the most common severe congenital malformations, caused by incomplete closure of the neural tube in the third and fourth weeks after conception. This study aimed to investigate potential maternal and environmental risk factors associated with NTDs in newborns under the coverage of Mashhad University of Medical Sciences. Methods: A descriptive case-control study was conducted using the Integrated Health Information System. All NTDs newborns (n=126) were case identified while three times of the number of mothers of healthy newborns (n=378) were picked as controls. Maternal and neonatal factors like folic acid supplementation, maternal age, BMI, parity, smoking, passive smoking, consanguinity, and neonatal sex were collected and processed with SPSS 27 software. Chi-square, Fisher's exact test, and logistic regression were employed. Results: Among mothers of NTD-affected newborns, 20.6% reported folic acid supplementation versus 31.5% in controls (P=0.02). The gender of the newborn, mother's age, BMI, number of children, education level, kinship, history of having affected child, and history of stillbirth showed no significant difference between cases and controls. Logistic regression results showed that not taking folic acid increased the likelihood of NTDs by more than two times (OR=2.11, P=0.006). Conclusion: Maternal folic acid supplementation was significantly associated with reduced risk of NTDs. No significant relationship was found with the other factors studied.