U-M Neurosurgeon Urges Women to Protect their
Children by Taking Folic Acid
In her career as a pediatric neurosurgeon, Karin Muraszko,
M.D., has helped hundreds of children born with debilitating
spinal birth defects while coping with the effects of
her own, a mild form of spina bifida.
all women of childbearing age took vitamin supplements and changed
their diets to include more foods rich in folic acid, Muraszko
explains, the result could be fewer babies born with neural
tube defects abnormalities in the developing brain or
Folic acid appears to be extremely important in the development
of the fetus, Muraszko says. Its vital for
women in their childbearing years, because it affects the fetus
at a crucial time in development when the brain and spinal cord
are forming. Since this occurs within the first four to six
weeks, generally before a woman even knows shes pregnant,
its extremely important that women take folic acid before
they become pregnant.
The same advice holds true for women in their child-bearing
years who arent even planning to have a baby, Muraszko
adds, since more than half of pregnancies arent planned.
Thats why many experts suggest that all women of childbearing
age take a daily multivitamin that contains the recommended
400 micrograms of folic acid.
Muraszko hopes her messages can help reduce the number of children
coming to her for help. As chief of pediatric neurosurgery,
I spend much of my time caring for children with complex neural
tube defects, and I see the effect it has on their lives,
she explains. And as someone with a mild form of spina
bifida, I know what its like to live life with a disability.
How can such a simple nutrient stop such a complex problem?
The exact mechanism is unclear, but Muraszko explains that it
has to do with the intricate process of fetal development, in
which different tissues and organs form during pregnancy. The
neural tube is the structure within the fetus that develops
into the brain and spinal cord. In most cases, the process goes
smoothly. But in some pregnancies, something goes wrong during
neural tube development.
If the brain develops abnormally, the child can be born with
a condition called an encephalocele, in which the brain is not
entirely contained within the skull. Or they can fail to develop
a full brain, a fatal condition called anencephaly that usually
results in miscarriage or death soon after birth. A birth defect
caused by a problem in spinal cord and spine development is
called spina bifida, and can range from a small defect in the
spine to a serious condition called a myelomeningocele.
In these children, the spinal cord doesnt form
properly. It is simply an open flat area in which there isnt
any covering on the spinal cord, Muraskzo says. This
happens within the first month of pregnancy, and these children
are affected for the rest of their lives. They often have other
anomalies, which make it difficult for them to walk and control
their bladder and bowel. They often have difficulties with brain
development, as well.
The fact that theres an easy way to prevent such dramatic
and life-altering conditions should be enough to convince women
to get more folic acid, Muraszko says. Scientific studies have
shown that a significant number of neural tube birth defects
could have been prevented, if only the mothers had gotten enough
folic acid before and during pregnancy.
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Fast Facts about Folic Acid
Folic acid is a common B vitamin found naturally in grains,
fruits, leafy green vegetables and beans. It is also available
in synthetic form in vitamin tablets and in fortified foods.
Neural tube defects are birth defects that occur in about 2,500
babies and numerous stillborn and miscarried fetuses each year
in the U.S. The defects occur when development of the brain
or spine during pregnancy does not progress normally.
Evidence suggests that more than half of all neural tube defects
could be prevented if women got enough folic acid during pregnancy.
Since more than half of all pregnancies are unplanned, its
important for all women of childbearing age to get enough folic
acid all the time, in case they become pregnant. Many neural
tube defects occur before a woman even knows shes pregnant.
Folic acid may help prevent heart disease, stroke and other
birth defects. The recommended daily dose of folic acid for
all adults is 400 micrograms per day. Many multivitamins contain
this much, and breads and cereals are fortified with extra folic
To learn more about folic acid, check these Web sites: