Neural Tube Defects

Neural Tube Defects

I am planning to conceive a baby and my Gynaecologist has recommended “Pre-conceptional Folic Acid Supplementation”, to prevent “Neural Tube Defects” in the baby.

What are these defects and and what is the recommended dose of Folic Acid?

Neural Tube Defects are congenital abnormalities or structural birth defects.
These defects are primarily caused by the failure of development in the structures that form and enclose the spinal cord and brain in the first four weeks of growth of the embryo.

57% of these defects are Spina Bifida,which is incomplete closure of the spinal cord.This leads to loss of sensation and muscle control below the defect.Sometimes there is herniation of the spinal cord and brain through the defect,resulting in Meningocoele, Meningomyelocoele and Meningoencephalocele..

Anencephaly is a condition in which the brain fails to develop normally and leads to death . Less serious forms of NTD’s require multiple surgeries for correction and cause significant disabilities,such as paralysis or weakness of the lower linbs,lack of bowel or bladder control,or hydrocephalus,which is increased fluid in the brain.

Annually,worldwide 3-4 lakh infants are born with spina bifida and anencephaly.The prevalence is1-5 per 1000 live births,and the rate of recurrence is 2-3%.

It is an accepted scientific fact, that prevalence of NTD’s in offspring, is associated with folic acid deficiency in the mother.

Surveys conducted in India have reported that only 20% women had heard about folic acid,and few of them knew that it should be taken before pregnancy,or that it prevents birth defects.

Periconceptional supplementation with folic acid has confirmed usefulness in reduced first occurrence and recurrence of NTD’s.

Women who are planning a pregnancy should take 0.4 mg [400 micrograms] daily to reduce the risk of NTD’s.

The dietary sources of folic acid are liver,legumes,green vegetables and citrus fruits.

However, folic acid naturally contained in food is less readily absorbed than a vitamin supplement of folic acid.

Hence,women of reproductive age are adviced to take 0.4 mg of folic acid daily in addition to eating a healthy folate rich diet to reduce the risk of serious NTD’s.

Those who are planning a pregnancy should start at least 1 month prior to conception and continue for the next three months of pregnancy when the baby’s organs are being formed.

In Western countries, implementation of food fortification with folic acid, like wheat, has resulted in 78 % decrease in the rate of NTD’s.

In India too,tremendous efforts through numerous government schemes have been activated aiming to uplift the benefit of vitamin fortified foods.