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New research shows that low vitamin B12 and folate levels in fathers — not just mothers — are linked to a higher risk of birth defects. A large cohort study of over 23,000 parents in China found that paternal deficiencies were as impactful as maternal ones, with B12 showing the strongest association. Experts say this should shift preconception care to include both parents.
We've long known that moms-to-be need adequate folate and B12 to reduce birth defect risk — but a new study published in Annals of Internal Medicine suggests dads need to pay attention to their nutrient levels too. Researchers analyzed blood samples from more than 23,000 parents in China and found that low concentrations of both vitamins in fathers during conception and early pregnancy were significantly associated with higher rates of birth defects in their children.
The findings mark a notable shift from the traditional maternal-focused narrative. Paternal B12 deficiency (< 148 pmol/L) was linked to a predicted prevalence of 55.5 defects per 1,000 births — slightly higher than the maternal figure of 49.6. Researchers suggest that insufficient folate in fathers may alter sperm epigenomes, influencing fetal development beyond just genetic contribution. Notably, more than half of the 400 recorded defects affected the heart, broadening the conversation beyond neural tube defects.
By the Numbers:
Why it matters: This study broadens the scope of preconception care, suggesting that optimizing nutrition in both parents — not just mothers — could meaningfully reduce structural birth defects, including heart defects. Clinicians may want to start factoring paternal nutritional status into preconception counseling conversations.
