Women Of Childbearing Age Urged To Take Folic Acid Supplements

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Main Category: Women's Health / Gynecology
Also Included In: Pregnancy / Obstetrics;  Pediatrics / Children's Health;  Neurology / Neuroscience
Article Date: 02 Sep 2009 - 7:00 PDT

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Following a report by the Scottish Spina Bifida Association (SSBA) that showed 15 babies have been born with the condition in Scotland since January, double the usual figure, sexually active women of childbearing age are being urged to take supplements of folic acid, even if they are not planning to have children, because research suggests that in many cases it is taken too late.

Dr Margo Whiteford, Chair of the Scottish Spina Bifida Association, who is also a consultant geneticist, told BBC News Scotland that the organization has received as many contacts from families in the first half of 2009 as they would expect for the whole year.

She said they couldn't tell if this was because of folic acid, but there is evidence that most women don't take enough folic acid and they don't take it at the right time. While many women know about folic acid preventing spina bifida, they don't start taking it until they've missed a period, which is too late for the developing fetus.

"The spinal cord develops within the first four weeks of pregnancy so by that stage it's too late - if the baby's going to have spina bifida it will already have developed it," explained Whiteford.

Because so many pregnancies are unplanned, to significantly reduce the number of children being born with spina bifida, all sexually active women of childbearing age should take folic acid supplements, says the Scottish Spina Bifida Association.

Spina bifida is Latin for "split spine". It's a condition where the bones in the spine that surround the spinal cord don't fuse together properly, allowing the bundle of nerves to protrude out of the spine. It starts during the early stages of fetal development and often before a woman even realizes she is pregnant.

The result is often that a sac of fluid comes through the opening in the baby's back, and in most cases part of the spinal cord is in this sac and is damaged.

With the right support, most children born with spina bifida go on to live full lives, but they often need surgeries and have lifelong disabilities, including being paralysed from the waist down and having problems with bowel and bladder functions. Sometimes there is also brain damage.

The Scottish Spina Bifida Association (SSBA) says about three quarters of cases could be prevented if women of childbearing age started taking folic acid regularly about 3 months before conception and continued while pregnant.

According to the BBC report, Scotland has the highest proportion of children born with spina bifida in the UK because pregnant women in Scotland are less likely to have an abortion when they discover their unborn baby has the condition.

There are no reports yet of a similar rise in spina bifida cases in the rest of the UK.

The Food Standards Agency (FSA) recommends that pregnant women take a 400 mg daily supplement of folic acid for the first trimester. There was a recommendation to add folic acid to bread flour as a way to protect unborn children, but it is now under review because new research suggests this might lead to more cases of colorectal cancer.

The FSA said that apart from pregnant women, people should get all the folic acid they need from eating a balanced diet.

-- more info on folic acid from the SSBA

Sources: BBC News, Scottish Spina Bifida Association, CDC.

Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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