Jennifer Wider, MD
SWHR Contributing Writer
October 25, 2010
October marks National Spina Bifida Awareness Month, a condition that affects thousands of American babies each year.
Spina Bifida is a birth defect caused by the incomplete closing of the neural tube during embryonic development. The neural tube is a structure that ultimately forms the baby’s brain and spinal cord and their surrounding tissues. In normal fetal development, the neural tube forms early on in pregnancy and closes several weeks thereafter. In babies with Spina Bifida, a portion of the tube fails to close properly, which can lead to defects in the back bone and spinal cord.
According to statistics from the Spina Bifida Association of America (SBAA), Spina Bifida is the most common, permanently disabling birth defect in the United States. Every day, roughly eight babies are born with Spina Bifida or a related birth defect in this country.
While the exact cause of Spina Bifida is not entirely known, there are several recognized risk factors. According to information from the Mayo Clinic’s Foundation for Education and Research, the following are the most common risk factors:
- Family history: Women who have given birth to one child with a neural tube abnormality seem to have a higher risk of occurrence in subsequent children.
- Race: Spina Bifida seems to more common in Caucasian and Hispanic populations.
- Folic Acid deficiency: A nutritional deficiency of folate (or folic acid), vitamin B9, increases the risk of Spina Bifida and many other neural tube defects.
- Certain medications: Research studies have shown that certain drugs including anti-seizure medications may interfere in the body’s ability to utilize folic acid and can lead to an increase in neural tube problems.
- Obesity: Women who are obese prior to and during their pregnancies have a higher risk for Spina Bifida and other known neural tube deformities.
While some of the risk factors cannot be controlled, others including diet and vitamin supplements clearly make a difference. “Folic acid dietary supplementation appears to reduce the occurrence of Spina Bifida and other neural tube defects,” explains William Graf, MD, Director of the Yale/New Haven Hospital Spina Bifida Program in Connecticut. “Clinicians in the United States should advise women without a family history of NTDs (neural tube defects), who anticipate a pregnancy to take .4-.8 mg (400-800 micrograms) of folic acid daily.”
According to data from the SBAA, “if all women who could possibly become pregnant were to take a multivitamin with folic acid, the risk of neural tube defects like Spina Bifida could be reduced by up to 70 percent.” Because many pregnancies are unplanned, most experts recommend women in their childbearing years to take the recommended dose of 400 micrograms of folic acid. Folic acid can be found in foods including: dark, green leafy vegetables, whole wheat products, nuts and seeds, oranges, grapefruits and fortified cereals and grains.
It is important for women to realize the cause of Spina Bifida is not clearly understood and most likely results from an interplay of many factors, including: nutritional, environmental and genetic. According to Dr. Graf, “there has been a slight miscommunication that folic acid will completely prevent this very complex, early neurodevelopmental disorder.” Thus, if a woman has a family or personal history of neural tube defects, it is important she speaks to her health care provider about how to further reduce the risk for her offspring.
