July 9 2004

LA COLUMNA VERTEBRAL
El Soporte Informativo Para Millones de Hispanos
By Beverly Lyles

Take Folic Acid to Reduce the Risk of Serious Birth Defects

Hispanic women have two times the risk of delivering a baby with a neural tube defect (NTD) than other women of childbearing age in the United States.  One reason for this may be that Latinas simply do not get enough folic acid. Folic acid, a B vitamin, can reduce neural tube defects by as much as 70 percent when taken before pregnancy, and in the early weeks of pregnancy.

Neural tube defects occur in the first month of pregnancy during the first four weeks, or 28 days. The two major   kinds of these defects are Anencephaly and Spina Bifida.  Anencephaly is the partial or complete absence of the baby’s brain. Most anencephalic babies are stillborn or die soon after birth.   Spina Bifida, the most common typeof NTD, occurs when part of the spine does not close. In more severe forms of this disease, the baby is born with its spinal cord and coverings protruding through the unclosed spine causing nerve damage and usually some degree of paralysis.

Risk factors for Neural Tube Defects?

A number of factors place a fetus at risk of neural tube defects.  A well-documented correlation has been established between lack of daily dietary folic acid (440 micrograms) and birth defects.   Studies also show that cigarette smoking, excessive drinking of alcohol, and long use of birth control pills actually lower the amount of folic acid in a person’s body. Between 2000- 2001, Dr. Hernández-Díaz and colleagues found that certain drugs taken by pregnant women to treat infection related to HIV, and in some cases epilepsy or seizures, have been linked to a seven times greater incidence of neural tube defects in their unborn.  If you fall into any of these categories, it is even more important that you take a multivitamin with folic acid every day.

Other Risk Factors

In addition to the mother’s low dietary intake of folic acid, other factors- genetic, environmental, and pharmacological- may affect fetal brain and spine development.

Pollutants, and poor or toxic working environments have recently been associated with a higher risk for neural tube defects.  Rates of Anencephaly and Spina Bifida also are usually higher in groups with lower socioeconomic status; and this association persists even after adjustment for intake of folic acid.

Recent studies done by the CDC along the US-Mexico Border, support but do not confirm these associations - suggesting that environmental pollutants, aberrant living conditions, and hazardous factory work  -at minimum - may have contributed to an unusually high number of neural tube defective births recently among Latinas living and working on the US-Mexico Border.

Researchers have long known of the increased risk to families for having a second or third child with neural tube defects as well.  But specific genetic factors that predispose a family to multiple neural tube births have still not been identified.  Even with genetic risks, over ninety-five percent of neural tube defects occur in families where there has never been an affected child.

In the United States alone, the  estimated total cost of Spina Bifida over a lifetime for affected infants born in 1988 is $500 million, or $294,000 for each infant.

If you suspect  you are pregnant or are planning to become  pregnant,  the time to take folic acid is now. If you  currently  take a medication  to control a chronic condition, it is important that you consult with your physician right away, and discuss the best treatment  options for  you and your unborn child.

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