Wang Zhi-Ping, Shang Xiao-Xiao, Zhao Zhong-Tang
Department of Epidemiology and Health Statistics, Shandong University, Jinan, Shandong, China.
J Matern Fetal Neonatal Med. 2012 Apr;25(4):389-94. doi: 10.3109/14767058.2011.580800. Epub 2011 Jun 1.
The objective of this study was to assess whether low level of maternal vitamin B(12) is associated with an increased risk of fetal neural tube defects (NTDs), in order to contribute to research on further reduction of NTDs under a background of mandatory folic acid (FA) fortification.
A meta-analysis was conducted. We retrieved and evaluated the studies published on the risk of low level of maternal vitamin B(12) for NTDs. The homogeneity of the studies was examined using the forest graph. Meta-analysis was applied to calculate the odds ratio (OR) of fetal NTDs in relation to low maternal B(12) and its 95% confidence interval (CI).
We identified nine published articles including 567 cases and 1566 controls in the meta-analysis. All the studies selected were homogeneous according to the forest graph (χ(2) = 15.05, P < 0.1). The estimated OR value of fetal NTDs in relation to low maternal B(12) was 2.41 (95% CI: 1.90-3.06).
Low maternal B(12) status could be an important risk factor for the development of fetal NTDs. The addition of synthetic B(12) to current recommendations for periconceptional FA tablet supplements or FA-fortified foods should be considered.
本研究的目的是评估孕妇维生素B12水平低是否与胎儿神经管缺陷（NTDs）风险增加相关，以便在强制叶酸（FA）强化的背景下为进一步降低NTDs的研究做出贡献。
进行了一项荟萃分析。我们检索并评估了已发表的关于孕妇维生素B12水平低与NTDs风险的研究。使用森林图检查研究的同质性。应用荟萃分析计算胎儿NTDs与孕妇低B12水平相关的比值比（OR）及其95%置信区间（CI）。
在荟萃分析中，我们确定了9篇已发表的文章，包括567例病例和1566例对照。根据森林图，所有入选的研究都是同质的（χ(2)=15.05，P<0.1）。胎儿NTDs与孕妇低B12水平相关的估计OR值为2.41（95%CI：1.90-3.06）。
孕妇B12水平低可能是胎儿NTDs发生的一个重要危险因素。应考虑在当前关于孕前FA片剂补充剂或FA强化食品的建议中添加合成B12。
