Neural tube defects (NTD) are the most common congenital birth defects. The reason for the NTD cause is still not completely known, but it is believed that some genetic and environmental factors might play a role in its etiology. Among the genetic factors the polymorphism in the folate gene pathway is crucial. Numerous studies have suggested the possible role of maternal higher plasma concentration of homocysteine and low concentration of folate and cobalamin in the development of NTD but some negative studies are also published. So, in this study, authors tried to find out the exact relation between NTD and maternal biomarkers like folate, cobalamin and homocysteine by conducting a meta-analysis. Different electronic databases were searched for the eligible studies. Standardized mean difference (SMD) with 95% confidence interval (CI) was used to determine association between maternal markers as risk for NTD pregnancy. The p value <0.05 was considered statistically significant in all tests. All the statistical analyses were done in the Open Meta-Analyst program. The homocysteine is significantly associated with the increased risk of NTD (SMD= 0.57; 95% CI: 0.35-0.80, p= <0.001; I2= 93.01%), s-folate showed protective role in NTD (SMD= -0.48; 95% CI: -0.77 to -0.19, p= 0.001; I2= 95.73%), similarly cobalamin is also having protective role (SMD= -0.28; 95% CI: -0.43 to -0.13, p= <0.001; I2= 80.40%). In conclusion this study suggest that different maternal biomarkers may be used for the early prediction of the NTDs.

中文翻译：

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产妇生物标志物，用于神经管缺陷妊娠的早期预测

神经管缺陷（NTD）是最常见的先天性出生缺陷。NTD病因的原因尚不完全清楚，但据信某些遗传和环境因素可能在其病因中起作用。在遗传因素中，叶酸基因途径中的多态性至关重要。大量研究表明，母亲血浆中同型半胱氨酸浓度较高，叶酸和钴胺素浓度较低可能在NTD的发生中发挥作用，但也发表了一些负面研究。因此，在这项研究中，作者试图通过荟萃分析来发现NTD与母体生物标志物（例如叶酸，钴胺素和高半胱氨酸）之间的确切关系。在不同的电子数据库中搜索了符合条件的研究。使用具有95％置信区间（CI）的标准化平均差异（SMD）来确定作为NTD妊娠风险的母体标志物之间的关联。在所有测试中，p值<0.05被认为具有统计学意义。所有统计分析均在Open Meta-Analyst程序中完成。同型半胱氨酸与NTD风险增加显着相关（SMD = 0.57; 95％CI：0.35-0.80，p = <0.001; I2 = 93.01％），s-叶酸对NTD具有保护作用（SMD = -0.48; 95 ％CI：-0.77至-0.19，p = 0.001； I2 = 95.73％），钴胺素也同样具有保护作用（SMD = -0.28； 95％CI：-0.43至-0.13，p = <0.001； I2 = 80.40 ％）。总之，这项研究表明，不同的母体生物标志物可用于NTD的早期预测。在所有测试中，0.05被认为具有统计学意义。所有统计分析均在Open Meta-Analyst程序中完成。同型半胱氨酸与NTD风险增加显着相关（SMD = 0.57; 95％CI：0.35-0.80，p = <0.001; I2 = 93.01％），s-叶酸对NTD具有保护作用（SMD = -0.48; 95 ％CI：-0.77至-0.19，p = 0.001； I2 = 95.73％），钴胺素也同样具有保护作用（SMD = -0.28； 95％CI：-0.43至-0.13，p = <0.001； I2 = 80.40 ％）。总之，这项研究表明，不同的母体生物标志物可用于NTD的早期预测。在所有测试中，0.05被认为具有统计学意义。所有统计分析均在Open Meta-Analyst程序中完成。同型半胱氨酸与NTD风险增加显着相关（SMD = 0.57; 95％CI：0.35-0.80，p = <0.001; I2 = 93.01％），s-叶酸对NTD具有保护作用（SMD = -0.48; 95 ％CI：-0.77至-0.19，p = 0.001； I2 = 95.73％），钴胺素也同样具有保护作用（SMD = -0.28； 95％CI：-0.43至-0.13，p = <0.001； I2 = 80.40 ％）。总之，这项研究表明，不同的母体生物标志物可用于NTD的早期预测。01％），s-叶酸对NTD具有保护作用（SMD = -0.48; 95％CI：-0.77至-0.19，p = 0.001; I2 = 95.73％），类似的钴胺素也具有保护作用（SMD = -0.28 ； 95％CI：-0.43至-0.13，p = <0.001； I2 = 80.40％）。总之，这项研究表明，不同的母体生物标志物可用于NTD的早期预测。01％），s-叶酸对NTD有保护作用（SMD = -0.48; 95％CI：-0.77至-0.19，p = 0.001; I2 = 95.73％），类似的钴胺素也有保护作用（SMD = -0.28 ； 95％CI：-0.43至-0.13，p = <0.001； I2 = 80.40％）。总之，这项研究表明，不同的母体生物标志物可用于NTD的早期预测。