Posts Tagged ‘neural tube defect’

Anencephaly: causes, risks & what you can do

Monday, January 25th, 2016

About 1,206 pregnancies are affected by anencephaly each year in the U.S.

Anencephaly is a serious birth defect in which a baby is born without parts of the brain, skull and scalp. As a baby’s neural tube develops and closes, it helps form the baby’s brain and skull, spinal cord, and back bones. Anencephaly is a type of neural tube defect (NTD) that happens if the upper part of the neural tube does not close all the way. A baby with anencephaly will be missing large parts of the brain that are necessary for thinking, hearing, vision, emotion and coordinating movement. Other parts of the brain are often not covered by bone or skin.

Babies born with anencephaly have reflexes such as breathing and response to touch and sound, however because of the severity of the condition, almost all babies with anencephaly die before birth or within a few hours or days after birth.

What causes anencephaly?

In most cases, the cause is unknown. Some cases are caused by a change in the baby’s genes or chromosomes. Anencephaly may also be caused by a combination of genes and other environmental factors. Scientists are continuing to study anencephaly in order to discover the causes.

What are the risk factors?

  • Low intake of folic acid before getting pregnant and in early pregnancy increases the risk of having a pregnancy affected by a NTD including anencephaly.
  • Babies born to Hispanic mothers are at an increased risk for anencephaly; reasons for the increased risk are not well understood.

How is anencephaly diagnosed?

  • During pregnancy: a woman can have screening tests done during her prenatal visits. Anencephaly would result in an abnormal result on a blood or serum screening test. Anencephaly might be seen during an ultrasound.
  • After a baby is born: anencephaly is immediately seen at birth.

Is there anything you can do to lower your risk?

Yes.

  • Take a multivitamin with at least 400 micrograms of folic acid every day before and early in pregnancy. Make sure to take your multivitamin even if you are not thinking about becoming pregnant any time soon. Since the U.S. started requiring that folic acid be added to certain foods, there has been a 28% reduction in cases of babies born with NTDs.
  • If you are pregnant, make sure you go to all of your prenatal visits and eat a well-balanced diet
  • Avoid alcohol and smoking and talk to your provider about any medications or drugs you are taking.

Have questions? Email us at AskUs@marchofdimes.org.

 

Birth defects

Friday, January 17th, 2014

In recognition of National Birth Defects Prevention Month, here are 10 things you need to know about birth defects from the Centers for Disease Control and Prevention, CDC.

1. Birth defects are common.
Birth defects affect 1 in 33 babies in the United States every year. For many babies born with a birth defect, there is no family history of the condition.

2. Birth defects are costly and can greatly affect the finances not only of the families involved, but of everyone.
In the United States, birth defects have accounted for over 139,000 hospital stays during a single year, resulting in $2.6 billion in hospital costs. Families and the government share the burden of these costs. Additional costs due to lost wages or occupational limitations can affect families as well.

3. Birth defects are critical conditions.
Birth defects can be very serious, even life-threatening.  About 1 in every 5 deaths of babies before their first birthday is caused by birth defects in the United States. Babies with birth defects who survive their first year of life can have lifelong challenges, such as problems with infections, physical movement, learning, and speech.

4. Women should take folic acid during their teens and throughout their lives to help prevent birth defects.
Because half of all pregnancies in the United States are not planned, all women who can become pregnant should get 400 micrograms of folic acid every day, either by taking a vitamin each day or eating a healthy diet. Folic acid helps a baby’s brain and spine develop very early in the first month of pregnancy when a woman might not know she is pregnant.

5. Many birth defects are diagnosed after a baby leaves the hospital.
Many birth defects are not found immediately at birth, but most are found within the first year of life. A birth defect can affect how the body looks, how it works, or both. Some birth defects like cleft lip or spina bifida are easy to see. Others, like heart defects, are found using special tests, such as x-rays or echocardiography.

6. Birth defects can be diagnosed before birth.
Tests like an ultrasound and amniocentesis can detect some birth defects such as spina bifida, heart defects, or Down syndrome before a baby is born. Prenatal care and screening are important because early diagnosis allows families to make decisions and plan for the future.

7. Birth defects can be caused by many different things, not just genetics.
Most birth defects are thought to be caused by a complex mix of factors. These factors include our genes, our behaviors, and things in the environment. For some birth defects, we know the cause. But for most, we don’t. Use of cigarettes, alcohol, and other drugs; taking certain medicines; and exposure to chemicals and infectious diseases during pregnancy have been linked to birth defects. Researchers are studying the role of these factors, as well as genetics, as causes of birth defects.

8. Some birth defects can be prevented.
A woman can take some important steps before and during pregnancy to help prevent birth defects. She can take folic acid; have regular medical checkups; make sure medical conditions, such as diabetes, are under control; have tests for infectious diseases and get necessary vaccinations; and not use cigarettes, alcohol, or other drugs.

9. There is no guaranteed safe amount of alcohol or safe time to drink during pregnancy.
Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person whose mother drank alcohol during pregnancy. These effects can include physical problems and problems with behavior and learning which can last a lifetime. There is no known safe amount, no safe time, and no safe type of alcohol to drink during pregnancy. FASDs are 100% preventable if a woman does not drink alcohol while pregnant.

10. An unborn child is not always protected from the outside world.
The placenta, which attaches a baby to the mother, is not a strong barrier. When a mother uses cigarettes, alcohol, or other drugs, or is exposed to infectious diseases, her baby is exposed also. Healthy habits like taking folic acid daily and eating nutritious foods can help ensure that a child has the best chance to be born healthy.
For more information: www.cdc.gov/birthdefects.

Written By: Cynthia A. Moore, M.D., Ph.D. Director
Division of Birth Defects and Developmental Disabilities
National Center on Birth Defects and Developmental Disabilities
Centers for Disease Control and Prevention

Folic acid helps prevent neural tube defects

Monday, January 6th, 2014

January 5-11 is National Folic Acid Awareness Week. Are you getting enough folic acid each day?

Today’s guest post is from the CDC’s National Center on Birth Defects and Developmental Disabilities.

Folic acid is a B vitamin. If a woman consumes the recommended amount of folic acid before and during early pregnancy, it can help prevent some major birth defects of the baby’s brain (known as anencephaly) and spine (known as spina bifida). Anencephaly is a serious birth defect in which parts of a baby’s brain and skull do not form correctly. Babies born with anencephaly cannot survive. Spina bifida is a serious birth defect in which a baby’s spine does not develop correctly, and can result in some severe physical disabilities. All women, but especially those who want to become pregnant, need 400 micrograms (mcg) of folic acid every day.

Do I need folic acid?

Yes! Every woman needs to get enough folic acid each day, even if she does not plan to become pregnant. This is because our bodies make new cells every day—blood, skin, hair, nails and others. Folic acid is needed to make these new cells. Start a healthy habit today and get 400 mcg of folic acid every day.

Why can’t I wait until I’m pregnant to start taking folic acid?

Birth defects of the brain and spine (anencephaly and spina bifida) happen in the first few weeks of pregnancy, often before a woman finds out she’s pregnant. Also, half of all pregnancies in the United States are unplanned. These are two reasons why it is important for all women who can get pregnant to be sure to get 400 mcg of folic acid every day, even if they aren’t planning a pregnancy any time soon. By the time a woman realizes she’s pregnant, it might be too late to prevent these birth defects. Starting today is the best option!

How do I get folic acid?

An easy way to be sure you’re getting enough folic acid is to take a daily multivitamin with folic acid in it. Most multivitamins have all the folic acid you need. If you get an upset stomach from taking a multivitamin, try taking it with meals or just before bed. If you have trouble taking pills, you can try a multivitamin that is gummy or chewable. Also be sure to take it with a full glass of water.

Folic acid has been added to foods such as enriched breads, pastas, rice and cereals. Check the Nutrition Facts label on the food packaging. A serving of some cereals has 100% of the folic acid that you need each day.

In addition to getting 400 mcg of folic acid from supplements and fortified foods, you can eat a diet rich in folate. You can get food folate from beans, peas and lentils, oranges and orange juice, asparagus and broccoli, and dark leafy green vegetables such as spinach, and mustard greens.
For More Information
CDC’s Folic Acid Homepage
Birth Defects COUNT
Spina Bifida Overview

Folic Acid: not just for neural tube defect prevention any more

Monday, February 18th, 2013

Taking a folic acid supplement daily, one month before becoming pregnant and throughout the first trimester, is one of the easiest and most effective steps women can take to prevent birth defects.  This simple step, taking 400 micrograms of folic acid daily, can reduce the chance of having a neural tube defect by 50-70%.

Last week, additional good news about the benefits of folic acid were announced in a study from Norway that was published in the Journal of the American Medical Association (JAMA).  In the study, pregnant women filled out a questionnaire reporting their use of folic acid from 4 weeks before to 8 weeks after the start of pregnancy.   Over 85,000 babies born to these women between 2002-2008 were followed for an average of 6 years.  Over the course of the study, 270 children were diagnosed with an autism spectrum disorder (ASD):  114 had autistic disorder, 56 had Asperger syndrome, and 100 had pervasive developemental delay – not otherwise specified (PDD-NOS).   The study found that children whose mothers reported taking folic acid were almost 40% less likely be diagnosed with autistic disorder than those whose mothers did not take it.

This is good news for women who want to do everything they can to prevent autism.  Autism is a complex neurodevelopmental condition with impaired social interaction and communication.  More research is needed to better understand its cause(s), which likely have both genetic and environmental contributions.  But in the meantime, preventing autism is yet another benefit to taking folic acid.

Read more and see our video on folic acid at this link.

Today’s guest post is from Dr. Siobhan Dolan, Associate Professor in the Department of Obstetrics & Gynecology and Women’s Health at the Albert Einstein College of Medicine and an attending physician in the Division of Reproductive Genetics at Montefiore Medical Center, the University Hospital for Einstein, in New York City. She is co-author of the new March of Dimes pregnancy book, Healthy Mom, Healthy Baby.

What is amniotic band syndrome?

Thursday, January 17th, 2013

Amniotic band syndrome is a well-know condition that can include a variety of different birth defects, usually affecting an arm or leg, fingers or toes. No two cases are alike – some are just a single malformation while others can include many disfiguring complications.

The upper body is involved more often than the legs or toes. (If you’re watching the current season of “The Bachelor” on TV, one of the women on the show is missing the lower part of an arm due to amniotic band syndrome.) Sometimes fingers or the lower portion of an arm are smaller than normal, sometimes they are missing all together, or occasionally some fingers may be webbed together. Sometimes a limb may have a deep groove around it showing where a tight band constricted growth.

In other cases, aside from defects of the arms or legs, a baby may also have facial defects (cleft lip or palate), a neural tube defect of the brain or spine, or have portions of internal organs protruding through a hole in the abdominal or chest wall.

The causes of amniotic band syndrome are yet unknown, but there are two main theories. One is that strands of tissue from the inside of the amniotic sac surrounding the developing baby separate from the lining and form bands that float free and entangle parts of the baby. If they wrap too tightly, they can restrict movement, blood flow and proper development, possibly even amputation. This may be due to random chance or trauma to the abdominal area and placenta during pregnancy.

Another theory holds that the cause stems from within the baby itself and involves insufficient blood flow to specific parts of the body. If an area of the body does not receive enough blood, tissues in that area die which can lead to physical defects. Some researchers believe that genetic factors may be involved in these cases. But whether this is caused from within the developing baby or from outside influences, occurrence is random and the chance of having another child with amniotic band syndrome is extremely low.

Treatment really depends on the severity of the defects. Surgery may be recommended to repair defects such as cleft lip or palate, clubfoot, or abdominal wall defects, etc. Sometimes physical or occupational therapies are needed to ensure the child has the best range of motion and use of the affected limb as possible.

Folic acid helps prevent birth defects

Friday, January 4th, 2013

Anifa is an 18-month-old girl who was born with spina bifida, a serious birth defect of the spine. Like many children with spina bifida, Anifa is paralyzed and has no bowel or bladder control. She lives with her family in a village in Nigeria where there is no primary health center to help her. As a result, Anifa could not have surgery to close the opening in her spine until she was nine months old. During this time, her spinal cord was exposed and without protection. In the U.S., the first surgery for a baby born with spina bifida usually takes place within the first 24 hours of life to avoid complications or death. But Anifa had no choice but to wait.

In the United States, children born with spina bifida often live long and productive lives, even though they face many challenges. In many other countries, however, the outlook for children like Anifa is not as positive.

The Centers for Disease Control and Prevention (CDC) first began researching folic acid’s role in preventing birth defects in the early 1980s. Early studies found the risk for having a baby with a neural tube defect (NTD), such as spina bifida, was reduced if the mother had taken folic acid before and during early pregnancy. As a result, U.S. Public Health Service released the 1992 recommendation that all women who could become pregnant should get 400 micrograms (mcg) of folic acid every day.

Women can get folic acid in three ways: diet, vitamin supplements, and flour fortification. Experts agreed that getting 400 mcg of folic acid from naturally-occurring food sources alone was impractical—women would have to eat a lot of folate-rich foods which are expensive and not readily available in many communities.

In January 1998, in response to requests from the CDC and its collaborators, including the March of Dimes, the FDA mandated fortification of cereal grain products labeled as enriched in the United States. “At that point, we had what we thought was the best possible coverage of women of child-bearing age to get folic acid for the prevention of neural tube defects,” says former CDC scientist Joe Mulinare. With a 36 percent reduction in the rates of neural tube defects by the end of 2006, folic acid fortification was recently named one of the Ten Great Public Health Achievements in the United States.

Folic Acid Awareness Week is January 6-12th, 2013. We are honored to have this guest post from the CDC. Author: Christina Kilgo, MA, Health Communication Specialist and SciMetrika contractor for CDC’s National Center on Birth Defects and Developmental Disabilities.

Mom’s weight and baby’s health

Thursday, January 3rd, 2013

Overweight and obesity during pregnancy can cause health problems for your baby. You know that it’s not great for your health, but it can affect your baby’s well being, too. While most babies of overweight and obese women are born healthy, problems can include:
• birth defects, including neural tube defects (NTDs) which are defects of the brain and spine
• preterm birth
• injury, like shoulder dystocia, during birth because the baby is large
• Death after birth
• Being obese during childhood

Dr. Patrick M. Catalano, a highly renowned obstetrician, professor and researcher has focused on nutrition and metabolic conditions before and during pregnancy and how those conditions affect a fetus’ growth and how much body fat it gains. His research has shown that infants born to obese mothers and mothers who have diabetes are heavier at birth and have a higher risk of developing metabolic disorders, including insulin resistance, a precursor to diabetes.

Dr. Kathleen Maher Rasmussen and her students broke new ground in understanding the threat being overweight at conception has on successful breastfeeding.  We know that breast milk is the best food for babies during the first year of life. It helps them grow healthy and strong. Dr. Rasmussen’s work on over-nutrition found that there is delayed onset of milk secretion and shorter breastfeeding in women who were significantly overweight.

If a woman starts pregnancy at a healthy weight, it can not only lower the risk of preterm birth and birth defects, but can give her baby a healthier start that can have life-long benefits.

Fortification of corn masa

Friday, April 20th, 2012

corn-masaDid you know that Hispanic women are about 20 percent more likely to have a child with a neural tube defect (NTD), which includes spina bifida and anencephaly, than non-Hispanic white women?  Although the reasons for the disparity are not well understood, Hispanic women have been found to have lower intake of the B vitamin folic acid overall compared to non-Hispanic white women.

Serious birth defects of the brain and spine in America’s babies, particularly those of Hispanic origin, could be reduced if the nation’s corn masa flour products were fortified with folic acid, according to a new petition filed with the U.S. Food and Drug Administration (FDA) by a coalition of six organizations:
• Gruma Corporation
• Spina Bifida Association
• March of Dimes Foundation
• American Academy of Pediatrics
• Royal DSM N.V.
• National Council of La Raza

Fortification of enriched cereal grains such as bread and pasta with folic acid was mandated by the FDA in 1998. Corn masa flour, however, lacks federal regulatory approval for the addition of folic acid. The rate of NTDs in the U.S. has decreased by nearly one-third since fortification. Despite this success, about 3,000 pregnancies in the U.S. still are affected by NTDs annually and Hispanics have the highest rate when compared to other race or ethnic groups.

Corn masa flour is made from specially treated corn and is used to make products common in Latin American diets such as corn tortillas and tamales. The petitioners believe that by targeting traditional Hispanic food made with corn masa for folic acid fortification, it would be possible to lower the rate of NTDs among Hispanics, particularly Mexican-Americans. Studies have shown that folic acid works if taken before conception and during early pregnancy. Many countries in Latin America already allow fortification of corn masa products with folic acid, including Costa Rica, El Salvador and Mexico.

The FDA accepted the petition on April 17. The petition now will be reviewed by the agency, which is not required to follow a prescribed timetable on the approval process. “Adding folic acid to corn masa flour can successfully decrease neural tube defects in the Hispanic community,” said Dr. Jennifer Howse, President of the March of Dimes.  “This is a safe and effective way to address the disparities we see in the Hispanic community and will give even more babies a healthy start in life. I’d like to thank our fellow petitioners for their leadership on this important health issue. We look forward to the FDA’s determination on our petition.”

We’ll keep you posted on their response.

Targeted or advanced ultrasound

Tuesday, March 1st, 2011

A targeted or advanced ultrasound usually follows after a standard ultrasound if the provider has seen something questionable and wants to take a closer look at it. This exam is more thorough than a standard ultrasound and can take from 30 minutes to a couple of hours. Among other things, it provides a more detailed view of the baby’s head and spine and is 95% effective in diagnosing neural tube defects like spina bifida. It includes a full body scan measuring all of the long bones, identifying major organs, including the heart and brain, nose and mouth.

Doppler imaging is a technique that can measure tiny changes occurring within the body, such as the speed and direction of blood flow. Sound waves bounce off moving red blood cells and produce an image of blood flow, something a standard ultrasound cannot do. Women with high blood pressure may receive an ultrasound with Doppler imaging of the umbilical artery to see if the blood flow to the baby or placenta is as it should be or if it is being compromised in some way.

Fetal echocardiography uses ultrasound to take a closer look at a developing baby’s heart. It offers a far more detailed view of the heart and provides information about its structure and rhythm. Women who are at increased risk of having a baby with a congenital heart defect may be offered this scan. It can provide valuable information about the anatomy and function of different parts of the heart, such as the valves, and is often used to rule out a possible problem rather than find one. If a heart defect is found, further body scanning for other possible defects will be recommended. Problems with fetal heart rhythms can be treated during pregnancy but structural defects require treatment, possibly surgery, after the baby is born. Knowing about a heart defect in advance will help ensure the baby is born in a medical center equipped to perform specialized medical treatment on the baby shortly after birth.

Free folic acid

Thursday, April 1st, 2010

Kmart Pharmacy is committed to helping educate women about healthy pregnancies. As part of their efforts this year, Kmart pharmacies across the U.S. will provide one free month of folic acid to expectant mothers.

Folic acid is a B vitamin that can help prevent birth defects of the brain and spinal cord called neural tube defects (NTDs). Folic acid works to prevent these birth defects only if taken before conception and during early pregnancy. Folate is the natural form of folic acid that is found in many foods.

Because NTDs originate in the first month of pregnancy, before many women know they are pregnant, it is important for a woman to have enough folic acid in her system before conception. Studies show that if all women consumed the recommended 400 micrograms of folic acid before and during early pregnancy, up to 70 percent of all NTDs could be prevented.

Once you’re pregnant, you should increase your folic acid intake to at least 600 micrograms of folic acid. Your prenatal vitamin should have the right amount of folic acid you’ll need during pregnancy.

Most women should limit the amount of folic acid they take to 1,000 micrograms a day unless otherwise directed by a health provider. For example, women who have had a previous pregnancy affected by birth defects of the brain and spine and women with sickle cell disease should be sure to talk with their health providers about the need for more folic acid.

Folic acid is recommended for all women of childbearing age because about half of all pregnancies in this country are unplanned.  Kmart is stepping up to the plate to help.  From March 28 through May 1, customers can obtain folic acid when they fill their prescription at their local Kmart. Additionally, over-the-counter folic acid is available as part of this promotion. Limited quantities per store are available.