Researchers in Bangladesh studied how a vitamin called folate works with our genes to prevent spina bifida, a serious birth defect affecting the spine. They looked at DNA from babies born with and without this condition and found that folate intake during pregnancy may help protect babies, especially those with certain genetic risk factors. The study identified four specific genes that might be involved in this protection. While these findings are promising, scientists need to study more babies to confirm these results before making new recommendations.

The Quick Take

  • What they studied: Whether taking enough folate (a B vitamin) during pregnancy can protect babies from spina bifida, especially for families with genetic risk factors for this birth defect
  • Who participated: 208 infants in Bangladesh—112 babies born with spina bifida and 116 babies born without it. Researchers analyzed their DNA and their mothers’ folate intake and arsenic exposure
  • Key finding: The study found four specific genes that may interact with folate to affect spina bifida risk. When mothers had adequate folate intake, it appeared to reduce the harmful effects of certain genetic risk factors
  • What it means for you: If you’re planning pregnancy or are pregnant, getting enough folate may be especially important if spina bifida runs in your family. However, this is early research, and you should follow your doctor’s recommendations for prenatal vitamins

The Research Details

This study used a method called genome-wide association, which is like searching through an entire instruction manual (DNA) to find specific sentences (genes) that might cause problems. Researchers compared the DNA of babies born with spina bifida to babies born without it. They looked at whether mothers who ate more folate-rich foods or took folate supplements had different genetic patterns in their babies. They also measured arsenic in mothers’ fingernails as another environmental factor that might affect the results.

This research approach is important because spina bifida happens when both genes and environment work together. By studying both at the same time, scientists can understand how folate protects babies with certain genetic backgrounds. This helps explain why some families are more at risk and why folate supplements are so important for pregnancy

This study is preliminary research with a relatively small number of babies studied. The findings are ’nominal associations,’ meaning they’re interesting but not yet confirmed. The researchers themselves recommend that other scientists study larger groups of babies to verify these results. The study was well-designed and included important environmental factors like arsenic exposure, which is relevant in Bangladesh

What the Results Show

The researchers found four different locations in the DNA where genetic variations might affect spina bifida risk. Two of these locations were found in genes called WWOX and ISOC2. When the researchers looked at how folate intake changed these genetic effects, they found a gene called CNTN5 became important. This suggests that folate doesn’t just help everyone equally—it may be especially protective for babies with certain genetic patterns. The study shows that adequate maternal folate intake appears to reduce the risk from harmful genetic variations, though the exact mechanism isn’t yet understood.

The study also looked at arsenic exposure, which is a concern in Bangladesh where some water supplies contain arsenic. When researchers included arsenic levels in their analysis, a fourth gene location (CTNNA2) became associated with spina bifida risk. This suggests that both folate and arsenic exposure may work together with genes to influence birth defect risk. The findings indicate that environmental factors and genetics are deeply connected in ways we’re still learning about

Scientists have known for decades that folate prevents spina bifida, but this is one of the first studies to show how folate works with specific genes in a South Asian population. Previous research mostly studied European populations. This study adds important information showing that genetic risk factors may vary between different ethnic groups, and folate’s protective effect may work differently depending on which genes a baby inherits

This study is small—only 208 babies total—so the findings are preliminary. The results are ’nominally significant,’ meaning they’re suggestive but not definitive proof. The study was done in Bangladesh, so results may not apply equally to other populations. The researchers couldn’t measure folate intake perfectly because they relied on mothers’ memories. These limitations mean we need larger studies to confirm these findings before changing medical recommendations

The Bottom Line

Pregnant women and women planning pregnancy should continue taking prenatal vitamins with folate as recommended by their doctors (typically 400 micrograms daily, or 4,000 micrograms if there’s a family history of spina bifida). This research suggests folate may be especially important for families with genetic risk factors, but current recommendations already account for this. Women in areas with arsenic in water should discuss water safety with their healthcare provider. Confidence level: Moderate—this supports existing recommendations rather than changing them

Women planning pregnancy or currently pregnant should care about this research, especially those with a family history of spina bifida or neural tube defects. Women in Bangladesh and other areas with arsenic in water should pay special attention. Healthcare providers should be aware that genetic risk factors may vary by population. This research is less immediately relevant to men or non-pregnant women, though it’s good general knowledge

Folate works throughout pregnancy to prevent neural tube defects, which form in the first 28 days after conception—often before a woman knows she’s pregnant. This is why folate intake before pregnancy is crucial. If you’re planning pregnancy, start taking folate supplements now rather than waiting until you’re pregnant. The protective effects happen during early pregnancy development, not later

Want to Apply This Research?

  • Track daily folate intake by logging prenatal vitamin use and folate-rich foods (leafy greens, legumes, fortified grains). Set a daily reminder to take prenatal vitamins and log completion. Aim for 400-4,000 micrograms daily depending on family history
  • If not already taking prenatal vitamins, start a daily habit by linking vitamin intake to an existing routine (breakfast, bedtime). Add folate-rich foods to meals: add spinach to smoothies, beans to salads, or fortified cereal to breakfast. If you have family history of spina bifida, discuss higher-dose folate (4,000 mcg) with your doctor and track this specifically
  • Create a monthly checklist of prenatal vitamin adherence. Track dietary folate sources weekly. If planning pregnancy, monitor this for at least 3 months before conception. During pregnancy, maintain consistent tracking throughout the first trimester when neural tube development occurs. Share logs with healthcare provider at prenatal visits

This research is preliminary and has not yet been confirmed in larger studies. It should not replace medical advice from your healthcare provider. All pregnant women and women planning pregnancy should follow their doctor’s recommendations for prenatal vitamins and folate supplementation. If you have a family history of spina bifida or neural tube defects, discuss appropriate folate dosing with your healthcare provider. This article is for educational purposes and is not a substitute for professional medical advice, diagnosis, or treatment.