Consuming vitamin B3 during pregnancy might prevent birth defects and miscarriages, reveals new study

Consuming an extra amount of vitamin B3 might help prevent certain kind of complex birth defects and reduce miscarriages, according to the latest study published in the The New England Journal of Medicine. The vitamin B3 can help compensate for defects in the body's ability to make a molecule, called nicotinamide adenine dinucleotide (NAD).

The study showed that increasing levels of B3 during pregnancy might help overall rates of birth defects. To understand the reason behind the child born with defects and heart diseases, scientists from the Victor Chang Cardiac Research studied the genes that influence heart development.

The researchers analyzed the DNA of four families where the mothers had suffered multiple miscarriages or their babies were born with multiple birth defects, such as heart, kidney, vertebrae and cleft palate problems.

They found mutations in two genes that caused the child to be deficient in a vital molecule known as Nicotinamide adenine dinucleotide (NAD), which allows cells to generate energy and organs to develop normally.

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Sally Dunwoodie replicated these mutations in mice but found that could be corrected if the pregnant mother took niacin (vitamin B3).

Of course, more human studies are needed before doctors could recommend B3 supplements for pregnant women, says Matthew Vander Heiden, who studies the role of NAD in cancer biology at the Massachusetts Institute of Technology in Cambridge.

But the work opens a potentially exciting new area of research for developmental biologists: Trying to understand how cell metabolism affects development. Few people would have guessed that NAD deficiency causes birth defects, he says, “but it fits in with what we’ve been finding” about how NAD can influence cell growth.   

But there is also some kind of uncertainty among researchers for how NAD levels affect development because the molecule plays a key role in so many different cell functions. Dunwoodie says she has counted at least 95 genes that are involved in NAD levels in the body. It’s possible that mutations in any of those could leave a developing fetus vulnerable to birth defects, even if neither parent has any obvious symptoms. Extra vitamin B3 in a mother’s diet might help compensate for any of the faulty genes, she says.

Physicians already recommend that women consume specific amounts of folic acid or vitamin B9, to prevent spinal cord defects, but the new work is not enough to offer a similar proposal for B3. Researchers need to learn more about how pregnancy influences NAD levels in general, and what a healthy level is, Vander Heiden says.

It’s possible that the extra B3 in standard prenatal vitamins is already helpful. Too much niacin can cause dizziness, nausea, and diarrhea, but low doses don’t have any known side effects. “There’s little downside to adding a bit of niacin” to people’s diets, he says. If it could prevent even a few severe birth defects, “it’s a pretty exciting possibility.” 

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