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International Journal of Endocrinology
Volume 2017, Article ID 5846286, 5 pages
Review Article

Myoinositol: The Bridge (PONTI) to Reach a Healthy Pregnancy

Clinical Genetics, ASST Cremona, Via Concordia 1, 26100 Cremona, Italy

Correspondence should be addressed to Pietro Cavalli; ti.anomerc.eladepso@illavac.p

Received 30 May 2016; Accepted 20 November 2016; Published 15 January 2017

Academic Editor: John E. Nestler

Copyright © 2017 Pietro Cavalli and Elena Ronda. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The use of folic acid in the periconceptional period can prevent about 70% of neural tube defects (NTDs). In the remaining cases, no medical prevention is available, and those conditions should be defined as folate-resistant NTDs. Rodent models suggest that some folate-resistant NTDs can be prevented by inositol (myoinositol and chiroinositol) supplementation prior to pregnancy. Should folic acid be combined with myoinositol periconceptional supplementation to reduce the overall risk of NTDs even in humans? Hereafter, we discuss the results from the PONTI study that strongly support both the effectiveness and safety of myoinositol periconceptional supplementation in preventing human NTDs. We further report on the largest case series of pregnancies treated with myoinositol and folic acid. At our institution, a sequential study during 12 years involved mothers at risk of fetal NTDs, and 29 babies from 27 pregnancies were born after periconceptional combined myoinositol and folic acid supplementation. No case of NTDs was observed, despite the high recurrence risk in the mothers. Taken together, those data suggest that periconceptional folic acid plus myoinositol can reduce both the occurrence and recurrence risks of NTDs in a greater number of cases than folic acid alone.