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Br Med J. 1980 December 13; 281(6255): 1592–1594.
PMCID: PMC1715083

Increased risk of recurrence of pregnancies complicated by fetal neural tube defects in mothers receiving poor diets, and possible benefit of dietary counselling.


One hundred and seventy-four women who had previously had a child with a neural-tube defect were assessed retrospectively on the quality of their diets during the first trimester of that pregnancy, between pregnancies, and during the first trimester of other pregnancies. They were then studied prospectively during the first trimester of 186 following pregnancies and the outcome of these was recorded. One hundred and three women (with 109 pregnancies) were given dietary counselling before the pregnancy, the remaining 71 (with 77 pregnancies) not being counselled. Seventy-eight (72%) of the counselled women improved their diet compared with only nine (12%) of the uncounselled women. The difference was significant (p < 0.001). There were three recurrences of neural-tube defects in the counselled women (3%) and five recurrences in the uncounselled (7%). Although this difference was not significant, the relative risk in the counselled group was reduced to less than half of that in the uncounselled group. All eight recurrences occurred in the 45 pregnancies in women taking poor diets (18%), whereas there were no recurrences in the 141 other pregnancies. This difference is significant (p < 0.001). It is concluded that women receiving adequate diets have a lower incidence and recurrence of fetal neural-tube defects than women receiving poor diets and that dietary counselling may be effective in reducing the incidence of fetal neural-tube defects.

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Selected References

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  • Laurence KM, Carter CO, David PA. Major central nervous system malformations in South Wales. II. Pregnancy factors, seasonal variation, and social class effects. Br J Prev Soc Med. 1968 Oct;22(4):212–222. [PMC free article] [PubMed]
  • Carter CO, Evans K. Spina bifida and anencephalus in greater London. J Med Genet. 1973 Sep;10(3):209–234. [PMC free article] [PubMed]
  • Smithells RW, Sheppard S, Schorah CJ. Vitamin dificiencies and neural tube defects. Arch Dis Child. 1976 Dec;51(12):944–950. [PMC free article] [PubMed]
  • Carter CO, David PA, Laurence KM. A family study of major central nervous system malformations in South Wales. J Med Genet. 1968 Jun;5(2):81–106. [PMC free article] [PubMed]
  • Carter CO. Clues to the aetiology of neural tube malformations. Dev Med Child Neurol. 1974 Dec;16(6 Suppl 32):3–15. [PubMed]
  • THIERSCH JB. Therapeutic abortions with a folic acid antagonist, 4-aminopteroylglutamic acid (4-amino P.G.A) administered by the oral route. Am J Obstet Gynecol. 1952 Jun;63(6):1298–1304. [PubMed]
  • Choi NW, Klaponski FA. On neural-tube defects: an epidemiological elicitation of etiological factors. Neurology. 1970 Apr;20(4):399–400. [PubMed]
  • Kelsey JL, Dwyer T, Holford TR, Bracken MB. Maternal smoking and congenital malformations: an epidemiological study. J Epidemiol Community Health. 1978 Jun;32(2):102–107. [PMC free article] [PubMed]
  • Gal I, Kirman B, Stern J. Hormonal pregnancy tests and congenital malformation. Nature. 1967 Oct 7;216(5110):83–83. [PubMed]
  • SAXEN L, HJELT L, SJOSTEDT JE, HAKOSALO J, HAKOSALO H. Asian influenza during pregnancy and congenital malformations. Acta Pathol Microbiol Scand. 1960;49:114–126. [PubMed]
  • Smithells RW, Sheppard S, Schorah CJ, Seller MJ, Nevin NC, Harris R, Read AP, Fielding DW. Possible prevention of neural-tube defects by periconceptional vitamin supplementation. Lancet. 1980 Feb 16;1(8164):339–340. [PubMed]

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