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Ronald G. Munger, PhD, MPH; Robert F. Woolson, PhD
University of Iowa College of Medicine Iowa City

JAMA. 1989;262(12):1633-1634.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Mulinare and colleagues¹ reported an association between periconceptional use of multivitamins by women and subsequent reduced risk of neural tube defects among their infants. Dr Holmes,² in an accompanying editorial, interpreted this study as finding no protective effect of vitamins among black women, then speculated that genetic differences between whites and blacks may result in a greater responsiveness of whites to periconceptional vitamin supplements. Dr Holme's speculation is based on a failure to recognize the large type II error associated with small sample sizes and a faith in genetic determinism with no supporting data.

Any inferences regarding blacks in this study are hazardous because only 28 blacks were included among the cases reported in Table 2 of the article and only 2 of these reported vitamin use. If the true odds ratio among black women was similar to that found among white women (0.4), then . . . [Full Text PDF of this Article]

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