Exposure of methyl mercury in utero and the risk of neural tube defects in a Chinese population

•NTD cases had higher placental levels of methyl mercury than healthy controls.•Higher placental levels of methyl mercury were observed in two major NTD subtypes.•Risk of NTDs increased with increased methyl mercury levels in placental tissue. To determine if exposure to methyl mercury (MeHg) in utero is associated with an elevated risk of neural tube defects (NTDs), we measured its concentration in the placentas of 36 anencephalic and 44 spina bifida cases, as well as in 50 healthy controls. The median MeHg concentration in NTD cases (0.49ng/g) was higher than that in controls (0.33ng/g). The crude and adjusted odds ratios (ORs) for a MeHg concentration above the median were 3.54 (95% confidence interval (CI), 1.68–7.49) and 3.64 (95% CI, 1.66–7.99), respectively. Both anencephaly and spina bifida subtypes had higher levels of MeHg than the controls. NTD risk increased for subjects in the second and third highest tertile of MeHg concentrations, with an OR of 2.24 (95% CI, 0.93–5.40) and 2.85 (95% CI, 1.17–6.94), respectively. In summary, higher placental levels of MeHg are associated with an elevated risk of NTDs.