National Spina Bifida Awareness Month: Folic acid crucial to help prevent birth defects
Annette Ott of York, Pennsylvania, is on a mission to educate more women about folic acid’s importance in reducing the risk of the crippling birth defect spina bifida, which means cleft, or split, spine.
Ott considers her daughter Kaleigh to be one of the lucky ones. Ott gave birth to twin girls about 27 years ago, and Kaleigh was born with spina bifida, which caused paralysis of her bowel and bladder and some lower extremity issues. Most children born with spina bifida are wheelchair-bound and worse.
October is National Spina Bifida Awareness Month. Spina bifida can happen anywhere along the spine if the neural tube does not close all the way, according to the Centers for Disease Control and Prevention. When that occurs, the backbone that protects the spinal cord doesn’t form and close as it should. This malformation often results in damage to the spinal cord and nerves. The neural tube is the structure in a developing embryo that eventually becomes the baby’s brain and spinal cord and the tissues that enclose them.
Ott wants women of childbearing age to know the importance of taking folic acid to help prevent neural tube defects.
“I wish I would have known about folic acid,” Ott said. “Not that folic acid will eliminate every case of spina bifida, but it has been found to prevent it in many cases.”
How Does Folic Acid Help Prevent Birth Defects like Spina Bifida?
Folic acid, also called folate, is important in the development of a healthy fetus, according to the National Institutes of Health. Studies have shown that by adding folic acid to their diets, women of childbearing age significantly reduce the risk of having a child with a neural tube defect such as spina bifida.
The U.S. Public Health Service recommends that all women of childbearing age, regardless of whether they are trying to become pregnant, consume 400 micrograms of folic acid daily. Foods high in folic acid include dark green vegetables, egg yolks, and some fruits. Many foods—such as some breakfast cereals, enriched bread, flour, pasta, rice, and other grain products—are now fortified with folic acid. Many multivitamins contain the recommended dosage of folic acid as well, the NIH said.
What Causes Spina Bifida?
Experts aren’t certain what causes spina bifida. It’s thought to result from a combination of genetic, nutritional, and environmental risk factors, such as a family history of neural tube defects and folate (vitamin B-9) deficiency, for example, according to the Mayo Clinic.
Spina bifida occurs in the first few weeks of pregnancy, usually when women don’t realize they are pregnant. “So in most cases, before you know you are pregnant, it’s already happened,” Ott said.
Spina bifida also can be caused by a parent’s exposure to toxic chemicals in the environment or workplace. Joint parental occupational pesticide exposure has been positively associated with spina bifida, according to a study published by NIH.
Also, multiple studies have linked spina bifida to exposure to certain herbicides. During the Vietnam War in the 1960s, the U.S. military employed herbicides to destroy enemy crops and forest cover until 1970. In 1995, the U.S. National Academy of Sciences concluded that one birth defect, spina bifida, was associated with paternal exposure. Spina bifida was, by the 21st century, the only birth defect that the U.S. Veterans Administration connected to Agent Orange exposure.
Living with Spina Bifida
Each year, about 1,427 babies are born with spina bifida in the United States. An estimated 166,000 individuals with spina bifida live in the United States. In most cases, spina bifida is diagnosed before birth. However, some less severe cases may go unnoticed until after delivery. Very mild forms (spina bifida occulta), in which one or more vertebrae are malformed, may never be detected.
Closed neural tube defects consist of a diverse group of defects in which the spinal cord is marked by malformations of fat, bone, or meninges. In most instances, there are few or no symptoms. In others, the malformation causes incomplete paralysis with urinary and bowel dysfunction. In the third type, meningocele, spinal fluid and meninges protrude through an abnormal vertebral opening. Some individuals with meningocele may have few or no symptoms, while others may experience such symptoms as complete paralysis with bladder and bowel dysfunction.
Myelomeningocele, the fourth form, is the most severe and occurs when the spinal cord/neural elements are exposed through the spine’s opening, resulting in partial or complete paralysis of the parts of the body below the spinal opening. The impairment may be so severe that the affected individual is unable to walk and may have bladder and bowel dysfunction.
Spina bifida complications can range from minor physical problems with little functional impairment to severe physical and mental disabilities. Spina bifida’s impact is determined by the malformation’s size and location, whether it is covered, and which spinal nerves are involved.
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