Vitamin B8 may help prevent neural tube defects in high risk women

By Louisa Richards

- Last updated on GMT

UCL research suggests inositol and folic acid may be more effective than folic acid alone. © iStock.com / jovannig
UCL research suggests inositol and folic acid may be more effective than folic acid alone. © iStock.com / jovannig

Related tags: Folic acid, Neural tube defects

Women at risk of carrying babies with spina bifida and other neural tube defects may benefit from taking inositol, also known as vitamin B8, alongside folic acid during pregnancy, researchers have suggested. 

The research from a team at the University College London (UCL) Institute of Child Health, the research partner of Great Ormond Street Hospital in the UK, followed increasing concerns that many forms of neural tube defects (NTDs) are not responsive to folic acid supplementation.

The results published in the British Journal of Nutrition ​suggest adding inositol may be more effective than folic acid alone, but the scientists warned women should not stop taking folic acid, and any additional supplements should be taken under close medical supervision. 

Researchers from the PONTI study (Prevention of Neural Tube defects by Inositol) - funded by the children’s medical research charity Sparks and the Medical Research Council - hope to follow up with a large-scale controlled trial to further establish the effects of this vitamin on NTD. 

Study details

Of 99 women with a history of a NTD pregnancy, just under half agreed to be randomised to receive either a daily dose of 5 mg folic acid (the standard UK dose for women at high risk of NTD) plus 1 g of inositol, or 5 mg folic acid plus 1 g placebo, before conception and for three months after. 

Many of the women who chose not to be randomised also took the inositol supplement at the studied dose of their own accord, and their pregnancy outcomes were recorded. 

In total, thirty-three randomised pregnancies produced one NTD recurrence in the placebo plus folic acid group, and no recurrences in the inositol plus folic acid group. Of 22 pregnancies in the women who declined randomisation there were two NTD’s in women who took folic acid alone. 

No adverse pregnancy events were associated with inositol supplementation in the randomised group. 

Future research 

UCL's Professor Andrew Copp told us the results were encouraging, but failed to provide a statistically significant difference because of the low participant numbers. 

One of the aims of the PONTI pilot study was to assess the feasibility of a larger controlled trial, and a different trial design – perhaps multi-national - may be preferable, say the scientists. 

There was actually a surprisingly large number of women who declined to be randomised and just wanted to take the inositol, so that would clearly be a factor that would make it more difficult to do a randomised controlled trial – clearly you need a control group,​” said Professor Copp. 

Discussing future public health recommendations, he said: “The main folic acid trial was also of women with a history, and that was positive back in the 1980’s and that then led to all women having it recommended, although the evidence was for women at high risk, so it might go in the same way.

"We would do a further study, if that then showed us a positive outcome for women at high risk, maybe then the next thing would be to recommend it to all women, but that’s further down the line and I wouldn’t like to predict on that really.” 

The study was one of over 1000 research projects currently being carried out at Great Ormond Street Hospital and the UCL Institute of Child Health, to help develop treatments and cures for conditions affecting children and adolescents. 

Source: British Journal of Nutrition​ 

Published online ahead of print, http://dx.doi.org/10.1017/S0007114515005322 

Inositol for the prevention of neural tube defects: a pilot randomised controlled trial 

Authors: N.D.E Greene et al. 

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2 comments

B8+ Accumulating deficiencies

Posted by HARRY,

B8+CHOLINE, liver problems. + BALANCED FOLIC ACID need displayed in Adductor Minimus Transverse fibres

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folic acid doesn't always work

Posted by Doni,

Some people cannot use folic acid because they lack an enzyme that converts it to a useful form. I seem to be one of them. I now avoid products supplemented with folic acid and take 5'tetrahydrofolate or folinic acid. I learned this from Dr Jonathan Wright's former publication and have found it is known to several alternative health practitioners.

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