Periconceptional folate supplementation reduces the risk of neural-tub
e defects. We studied the frequency of the 677C-->T mutation in the 5,
10-methylenetetrahydrofolate reductase (MTHFR) gene in 55 patients wit
h spina bifida and parents of such patients (70 mothers, 60 fathers).
5% of 207 controls were homozygous for the 677C-->T mutation compared
with 16% of mothers, 10% of fathers, and 13% of patients. The mutation
was associated with decreased MTHFR activity, low plasma folate, and
high plasma homocysteine and red-cell folate concentrations. The 677C-
->7 mutation should be regarded as a genetic risk factor for spina bif
ida.