PREVENTION OF SPINA BIFIDA BY FOLIC ACID

Authors

  • Bojana Cokić "Zaječar" Health Center, Children's Department

DOI:

https://doi.org/10.46793/PP180218013C

Keywords:

Folic acid, Spina bifida, prevention

Abstract

Introduction: Folic acid is necessary for cell functioning  and normal development of new cells, for activation of some amino acids, for erythropoiesis. It is also important for the normal development of the neural tube. Therefore, it is very important in the development of the fetus. Prenatal use of folic acid, in primary and secondary prevention of defects of the neural tube, has been known for several decades. The paper presents well known evidence of the effect of folic acid on the prevention of defects in the neural tube, but also on the correct supplementation in pregnancy, and the possibility of the effect of folic acid supplementation on other outcomes of pregnancy.

Methodology: The survey was conducted in the Municipality of Zajecar. The incidence of children with defective neural tube in the period from 1987-2015 is shown. Data were obtained from Registery for congenital anomalies. Diagnosis in all children is postnatal. During the analysed period  there was 22 145 born children, and appart of that number there was 13 children with defective nerual tube, which means 0,587/1000  live newborns. Mothers of affected children have nt been on folic acid supplementation. After  2012. Folic acid was introduced during pregnancy, until 2015 no defective nerual tube in newborns at all.

Results: The results of our retrospecitve analyses show that the number of children with Spina bifida decreased when folic acid was introduced as supplementatuion before and during the pregnancy..

Conclusion: Folic Acid is important in preventing defects in the neural tube.

References

Grosse SD, Berry RJ, Tilford JM, Kucik JE, Waitzman NJ. Retrospective assessment of cost savings from prevention: Folic acid fortification and spina bifida in the U.S. American Journal of Preventive Medicine. January 2016.

Mertens P. Spina Bifida and primary prevention. Orphanet Journal of Rare Diseases 20127(Suppl 2): A18.

Osterhues A, Ali NS, Michels KB. The role of folic acid fortification in neural tube defects: a review. Crit. Rev. Food Sci. Nutr. 2013; 53, 1180–1190.

Patel N, Viguera AC, Baldessarini RJ. Mood. Stabilizing Anticonvulsants, Spina Bifida, and Folate Supplementation: Commentary. J Clin Psychopharmacol. 2018; Feb 38 (1):7-10.

Ricks, D. J. et al. Peru's national folic acid fortification program and its effect on neural tube defects in Lima. Rev. Panam. Salud Pubica 2012; 32, 391–398.

Systematic Reviews. Folic acid supplements before conception and in early pregnancy (up to 12 weeks) for the prevention of birth defects. 2015, Issue 12.

American Pregnancy Association 2017. Maternal Serum Alpha-Fetoprotein Screening (MSAFP) . 2016 Sep 2.

Schechter MS, Liu T, Soe M, et al. Sociodemographic Attributes and Spina Bifida Outcomes. Pediatrics. 2015 April; 135(4).

Saadai P, Farmer DL. Fetal surgery for myelomeningocele. Clinics in Perinatology 2012; 39 (2), 279–288.

American Association for Clinical Chemistry. 2017; Glossary: Spina Bifida.

National Center for Advancing Translational Sciences/Genetic and Rare Diseases. U.S. Department of Health and Human Services; Neural Tube Defects. 2017.

Copp AJ, Stanier P, Greene ND. Neural tube defects: recent advances, unsolved questions, and controversies. Lancet Neurol 2013;12: 799-810.

Oakeshott P, Hunt GM, Poulton A. et al. Open spina bifida: birth findings predict long-term outcome. Arch Dis Child 2012; 97, 474–476.

Juriloff DM, Harris M J. Hypothesis: the female excess in cranial neural tube defects reflects an epigenetic drag of the inactivating X chromosome on the molecular mechanisms of neural fold elevation. Birth Defects Res Clin Mol Teratol 2012; 94, 849–855.

Agopian AJ, Tinker SC, Lupo PJ, et al. Proportion of neural tube defects attributable to known risk factors. Birth Defects Res Clin Mol Teratol 2013; 97, 42–46.

Bahlmann F. et al. Cranial and cerebral signs in the diagnosis of spina bifida between 18 and 22 weeks of gestation: a German multicenter study. Prenat Diag 2014; 35, 228–235.

Adzick NS. Fetal surgery for myelomeningocele: trials and tribulations. Isabella Forshall Lecture. J Pediatr Surg 2012; 47, 273–281.

Murray CB et al. A longitudinal examination of health-related quality of life in children and adolescents with spina bifida. J Pediatr Psychol 2014.

Wilde J J, Petersen JR, Niswander L. Genetic, epigenetic, and environmental contributions to neural tube closure. Annu Rev Genet 2014; 48, 583–611.

Stubberud J, Langenbahn D, Levine B, et al. Emotional health and coping in spina bifida after goal management training: a randomized controlled trial. Rehabil Psychol 2014; 60, 1–16.

EUROCAT.Special Report: Prevention of Neural Tube Defects by Periconpceptional Folic Acid Supplementation in Europe. 2009

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Published

04/30/2018

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Original Articles