Neural tube defects (NTDs) are severe developmental abnormalities that affect a baby’s brain, spine, or spinal column. They affect around one in 1,000 pregnancies, with 190 babies born alive with an NTD in the UK every year.1-4 Taking folic acid can help prevent NTDs, but it is not always effective. Professor Nicholas Greene at the UCL Great Ormond Street Institute of Child Health is investigating if giving women a vitamin called inositol can also help protect babies inside the womb. He hopes that this could lead to a cheap, effective new approach to help reduce the number of babies born with NTDs in the future.
How are children’s lives affected now?
In early pregnancy, a structure forms in the developing embryo called the neural tube that eventually develops into the baby’s brain and spinal cord. It closes about four weeks after conception, but when something goes wrong, this can result in a neural tube defect – or NTD.
The most common NTD is spina bifida. Children with this condition may experience a wide range of symptoms that include difficulties with walking, incontinence, and learning difficulties. They usually need several operations and while most grow up to become adults sadly, their lives are often cut short.
Most NTDs are due to a combination of genetic and environmental risk factors, with a mother’s diet before and during early pregnancy playing an important role.
“Thankfully, women in the UK who are trying to become pregnant are now routinely advised to take folic acid, which can reduce the risk of their baby having an NTD,” says Professor Greene. “But this is not completely effective, so we need new approaches to protect more babies from these serious conditions.”
How could this research help?
“Our ultimate goal is to use a vitamin – called inositol – to reduce the risk of NTDs,” says Professor Greene. “As a cheap and readily available supplement, we’re excited about its potential to deliver benefits quickly.”
The team have already carried out a small clinical trial in the UK, with encouraging results. They now plan to find out more about the biological impact of inositol on the developing embryo – to understand how it works, how to use it most effectively, and identify any other unexpected effects.
Their results will help shape the design of a larger clinical trial to test whether the vitamin can truly help prevent babies from developing NTDs.
“Our hope is that one day taking inositol will mean fewer parents receiving heart-breaking news about their baby,” says Professor Greene. “And, as our knowledge about the genetic risk factors for NTDs improves, understanding how inositol and other nutrients help prevent these conditions could even pave the way towards personalised supplements for women planning a pregnancy.”
1.Morris JK. et al. Prevention of neural tube defects in the UK: a missed opportunity. Archives of Disease in Childhood. 2016; 101(7): 604-607. http://adc.bmj.com/content/101/7/604
2.Office for National Statistics: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarri... [website accessed 12 December 2017]
3.National Records of Scotland: 2016 Births, Deaths and Other Vital Events - Preliminary Annual Figures: https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-... [website accessed 12 December 2017]
4.Northern Ireland Statistics and Research Agency. Births. Live births 1887-2016. https://www.nisra.gov.uk/publications/monthly-births [website accessed 12 December 2017]
|Project Leader||Professor Nicholas D E Greene, MA PhD|
|Project Team||Professor Andrew J Copp, DPhil MBBS, FMedSci, FRCPath, FRSB|
|Project Location||Developmental Biology and Cancer Programme, UCL Great Ormond Street Institute of Child Health, University College London|
|Project duration||28 months|
|Date awarded||20 November 2017|
|Project start date||1 June 2018|
|Project end date||30 September 2021|