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Author Spotlight: Studying the Impact of Maternal Dietary Deficiencies on Long-Term Offspring Health Outcomes
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Maternal Folic Acid Supplement Use, Folate Intake, and Preterm Birth Among Infants With Spina Bifida.

Renata H Benjamin1, Katherine L Ludorf1, Rachel P Allred2

  • 1Department of Epidemiology, The University of Texas Health Science Center at Houston (UTHealth Houston) School of Public Health, Houston, Texas, USA.

Birth Defects Research
|December 12, 2025
PubMed
Summary

Maternal low folate intake combined with no folic acid supplementation modestly elevates preterm birth risk in infants with spina bifida. Further research is needed to confirm these findings and explore supplementation timing.

Keywords:
dietary folate intakefolic acid supplementationpreterm birthspina bifida

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Nutritional Science

Background:

  • Spina bifida is a severe birth defect with significant implications for infant health.
  • Folic acid supplementation is known to reduce the risk of neural tube defects like spina bifida.
  • The association between folate intake and preterm birth in spina bifida pregnancies requires further investigation.

Purpose of the Study:

  • To assess the relationship between folic acid supplementation, dietary folate intake, and preterm delivery in infants diagnosed with spina bifida.
  • To identify specific maternal nutritional factors that may influence pregnancy outcomes in spina bifida cases.

Main Methods:

  • Retrospective population-based study utilizing data from the National Birth Defects Prevention Study (NBDPS) and the Birth Defects Study To Evaluate Pregnancy exposureS (BD-STEPS).
  • Analysis included 1199 infants with spina bifida.
  • Robust Poisson regression was used to calculate risk ratios (RR) and 95% confidence intervals (CI) for preterm birth based on maternal folate status.

Main Results:

  • Among 1199 infants with spina bifida, 18.1% were born preterm.
  • No significant association was found between preterm birth and lack of folic acid supplementation alone or dietary folate intake quartiles alone.
  • A combination of no folic acid supplementation and low dietary folate intake showed the strongest association with preterm birth (RR 1.73, 95% CI: 1.01-2.96).

Conclusions:

  • A combination of no folic acid supplementation and low dietary folate intake is associated with a modestly elevated risk of preterm birth in infants with spina bifida.
  • Further research is warranted to confirm these findings and explore the impact of supplementation timing.
  • Low folate intake may be a contributing risk factor for preterm birth in pregnancies affected by spina bifida.