Posts Tagged ‘spina bifida’

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 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.

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.

Fetal surgery for spina bifida

Friday, February 11th, 2011

Pregnant women who learn that their developing baby has a birth defect of the spine, spina bifida, wish so much that there was something to be done that could help prevent the disabilities that come with this disorder. Often long-term survivors of spina bifida have paralysis and bowel and bladder dysfunction. In the past, doctors had to wait until after the baby was born to try to correct improper development, but by then much of the damage was irreversible. Today, however, surgery can be performed on some of these babies while they are still developing in the womb, giving them a better chance at avoiding disabilities later.

Scientists have been studying fetal surgery for years. Just recently, an exacting, multi-year, randomized clinical trial has shown that surgery on babies with a form of spina bifida produced much better outcomes if performed before birth rather than afterward.  Follow-up studies of the children showed that by the age of 12 months, far fewer babies who had fetal surgery required cerebrospinal fluid shunts. By the age of 30 months, these babies were more likely to walk without orthotics or devices and had fewer neurological problems than those who had corrective surgery after they were born.  It is believed that the early surgical repair allowed for more normal prenatal nervous system development.

This surgery is not without its risks.  It does increase the chance of premature rupture of the membranes, preterm birth, uterine scar defects and it mandates cesarean delivery in all subsequent pregnancies.

This exciting study, published in the New England Journal of Medicine on February 9th, is likely to generate interest in the possibility of other surgical procedures performed before birth.

Do those blood tests confuse you?

Monday, August 9th, 2010

For those of you who are pregnant, sometime between 15-20 weeks of pregnancy, you will be offered maternal serum screening.  What is this?  And more importantly, what do the results mean?  I think maternal blood screening is one of the most misunderstood tests in pregnancy.  And for some women it can be a very nerve-wracking experience.

The American College of Obstetricians and Gynecologists (ACOG) recommends that all pregnant women regardless of age be offered a screening test for Down syndrome and certain other birth defects.  This is a blood test that looks at the levels of either 3 or 4 (depending on the test) chemicals that are present in a pregnant woman’s blood.  The chemicals are AFP (alpha fetoprotein), hCG (human chorionic gonadotropin—the same chemical that a home pregnancy test measures), estriol, and recently most labs have added a fourth substance, inhibin A.  These chemicals are present in every pregnant woman’s blood.  Some of them are produced by the fetus while others are hormones produced by the placenta.

Maternal serum tests such as the triple screen or the quad screen as they are commonly called, look at the levels of these 3 or 4 chemicals in the mother’s blood and the woman’s age, weight, race, number of fetuses (e.g. twins) and whether she has diabetes that requires insulin treatment.  Then given all of those factors and the levels of the 3 or 4 chemicals the laboratory can determine the chance that a woman has a baby with Down syndrome, a neural tube defect (spina bifida), trisomy 18, or abdominal wall defects.

There are two different ways that the results may be reported.  A woman may receive her test result as a ratio. For example, her baby has a 1 in 500 chance for Down syndrome. Or, in some cases, a woman’s test results are reported as normal (screen negative) or abnormal (screen positive), depending on whether her results fall below or above a cut-off point (usually about 1 in 270).

The test is NOT a diagnosis of any of these conditions though.  This is where there is a lot of confusion.  By definition, screening tests do not diagnose a condition.  They only determine whether there is an increased risk for the condition.  The good news is that of all of the women who screen positive, only a small percentage will actually have a baby with one of these disorders.  Many times women have an abnormal result simply because their fetus is a few weeks older or younger than previously thought.

For women with abnormal results, the next step is usually an ultrasound. This test can check the gestational age of the fetus and show if a woman is carrying multiples. If either of these factors accounts for the abnormal test result, no further testing is needed. If ultrasound does not explain the abnormal test result, amniocentesis will be offered.  An amniocentesis is an invasive test where the doctor uses a needle to remove some of the amniotic fluid around the baby.  Although amnio does pose a very slight risk of miscarriage (1/4 of one percent or 1/500), it is extremely accurate and usually can give a pregnant woman a definitive answer.  Should a problem exist, arrangements can be made in advance for special care of the newborn at delivery.

Folic acid awareness – pay attention!

Tuesday, January 5th, 2010

grains-and-veggiesNot enough American women understand that consuming the B vitamin folic acid every day can help prevent serious birth defects and that they should take it before they become pregnant. Did you? 

Studies show that if all women consumed the recommended amount of folic acid before and during early pregnancy, up to 70 percent of all birth defects of the brain and spine known as neural tube defects (NTDs), such as spina bifida, could be prevented.  The most recent March of Dimes survey revealed that only 28 percent of women of childbearing age knew folic acid can prevent birth defects and only 11 said they knew that folic acid should be consumed prior to pregnancy.  Wow, those are really low numbers for something so important!

This January, as part of National Birth Defects Prevention Month, we’re trying to remind all women of child-bearing age of this really important role folic acid plays in preventing birth defects. Daily consumption of the B vitamin folic acid beginning before pregnancy is crucial because NTDs can occur in the early weeks following conception, often before a woman knows she is pregnant. 

We urge all women of childbearing age to consume 400 micrograms of folic acid daily.  Bread, crackers, bagels, pasta, pretzels and tortillas made from fortified, enriched white flour are popular and important sources of folic acid.  In fact, enriched grain products have been fortified with twice the amount of folic acid found in whole grain products. Other good sources are leafy green veggies like spinach and kale, dried beans, legumes, oranges and orange juice.  And you’ll find it in a daily multivitamin, too. 

Taking folic acid as part of your daily routine before, during and after pregnancy is a great New Year’s resolution!

Folic acid awareness week and birth defects prevention month

Monday, January 5th, 2009

Today is the first day of National Folic Acid Awareness Week. 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.

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. Folic acid is recommended for all women of childbearing age because about half of all pregnancies in the United States are unplanned.

We have a helpful video on folic acid that is apart of our Healthy Pregnancy, Healthy Baby video series. Click here to watch.

January is Birth Defects Prevention Month. The National Birth Defects Prevention Network’s Education and Outreach Committee developed a 2009 Birth Defects Prevention Month Packet focusing on “Obesity Prevention and Weight Management – Before, During, and After Pregnancy”. The packet materials are available by clicking here.  These resources can be shared with colleagues, policy makers, families, and others during Birth Defects Prevention Month and throughout the year.

Taking folic acid a year before pregnancy can reduce preterm birth.

Tuesday, July 1st, 2008

New research suggests that women who take a daily multivitamin containing 400mcg (micrograms) of folic acid for at least one year before they become pregnant can reduce their risk of having a premature baby by half. Click here to read the article, Huge Drop in Preterm Birth-Risk Among Women Taking Folic Acid One Year Before Conception.

Folic acid (synthetic form of a B vitamin) is also important for the development of the fetus’s neural tube, which becomes its brain and spinal cord. A lack of folic acid may result in a severe birth defect called a neural tube defect (NTD). Women who are or may become pregnant are encouraged to take folic acid supplements in addition to eating foods high in folate. Folic acid may also reduce the risk of stroke, colon cancer and breast cancer.

For more information about getting healthy before pregnancy watch the video, Don’t U Dare.