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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.

If 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 spinal cord.

“Folic acid appears to be extremely important in the development of the fetus,” Muraszko says. “It’s 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 she’s pregnant, it’s extremely important that women take folic acid before they become pregnant.”

The same advice holds true for women in their child-bearing years who aren’t even planning to have a baby, Muraszko adds, since more than half of pregnancies aren’t planned. That’s 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 it’s 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 doesn’t form properly. It is simply an open flat area in which there isn’t 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 there’s 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.

 

—Kara Gavin

 

Find the full text at
http://www.med.umich.edu/opm/newspage/folica.htm

 

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, it’s 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 she’s 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 acid.

To learn more about folic acid, check these Web sites:

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Copyright 2001 University of Michigan Medical School