MEDICAL SURFARI: PREVENT BIRTH DEFECTS

There are about 150,000 babies born each year in the United States with birth defects. About 2500 of these babies are born with a certain type of defect of the brain and spine called neural tube defects (NTDs). The neural tube is the embryonic structure that develops into the brain and spinal cord. This structure starts out as a flat disc of cells that normally fold into a tube by the 29th day after conception. An NTD develops if there is not a closure of this tube. The most common NTDs are spina bifida and anencephaly. Babies with anencephaly generally die shortly after birth and persons with spina bifida require surgery to correct the defect of the open spine. They often have varying degrees of paralysis of their legs, bowel and bladder. As a result, they may require life-long medical care including repeated hospitalizations for other associated medical problems. Folic acid, a B vitamin, can help prevent birth defects of the brain and spinal cord as well as other birth defects, including cleft lip and pallet. It should be taken before pregnancy and in the early weeks of pregnancy since NTDs develop within the first month of pregnancy. Unfortunately, 50 percent of pregnancies in this country are unplanned and only 23 percent of women who became pregnant in 1988 were taking folic acid supplements beforehand. By the time most women discover they are pregnant, this critical point in development has already passed. The Public Health Service and the Institute of Medicine have recommended that women capable of becoming pregnant take a daily folic acid supplement throughout their child-bearing years to reduce the risk of this kind of birth defect.

How much folic acid should women take? The March of Dimes recommends all women who can become pregnant, consume a multi-vitamin containing 400 mcg of folic acid daily in addition to eating a healthy diet including foods rich in folic acid. It is not enough to simply eat a well balanced diet as most women only get about 200 mcg of folic acid from their diets. This additional intake of B vitamin and folic acid could prevent 50 to 70 percent of NTDs. The natural form of folic acid found in food, folate, is present in citrus fruits and juices, leafy green vegetables, beans, peanut, broccoli, asparagus, peas and lentils, and whole grain products. Many breakfast cereals are now fortified with a synthetic, more easily adsorbable form of folic acid.

Neural tube defects are highly preventable before birth, but unfortunately about two thirds of the population go unprotected against the possibility of this defect. A recent survey by the Center for Disease Control revealed that fewer than one in five women hear about the importance of folic acid consumption from their physicians, and only one in three take folic acid regularly. The March of Dimes has implemented a folic acid campaign, the first phase of which will be sustained throughout the year 2000. This will involve community programs, professional education an mass media components. This year the focus will be directed primarily to women considering pregnancy so that they can make a behavior change for the health of their future baby.

If you are of child bearing age, and even if you do not plan to become pregnant, consider taking a multivitamin containing folic acid daily to prevent these type of birth defects.

Awareness of this condition and the need for sufficient folic acid prior to pregnancy is the key to preventing these defects. Please share this information with anyone that you know of childbearing age.

World Wide Web Resources

March of Dimes Home Page

http://www.modimes.org/

The Folic Acid Campaign from the March of Dimes Birth Defects Foundation has pledged to reduce the incidence of neural tube defects by at least 30 percent by the year 2001 by encouraging women of childbearing age to increase their intake of folic acid.

U.S. Food and Drug Administration Folic Acid Fact Sheet

http://www.babybag.com/articles/wh-folic.htm

The FDA recommendations regarding fortification of foods with folic acid and the rationale behind these recommendations are detailed at this site.

Prevent Birth Defects

http://www.shrinershq.org/Prevention/folic2-98.html

This web page form the International Shrine Headquarters provides some basic, easily understandable information regarding folic acid and it's role in preventing neural tube defects.