Spina bifida, or lack of posterior closure of the spine, Spina bifida. What is this ? is a congenital disease that results from a developmental disorder of the spinal cord and spine. This defect affects about 0.45 in every 1,000 pregnancies. Spina bifida is also called “neural tube defect”.
In addition to spina bifida, there are also other anomalies of the neural tube, such as anencephaly (absence of part of the brain) or encephalocele (externalization, due to an anomaly in the skull, of part of the brain as a hernia). The total prevalence of neural tube defects is approximately 1 in 1,000 pregnancies.
Spina bifida. What is this ?
Fortunately, taking folic acid supplements before and during pregnancy can significantly reduce the risk of spina bifida and other neural tube defects.
WHAT IS SPINA BIFIDA?
Spina bifida is a birth defect of the neural tube. This neural tube defect develops during the first weeks of pregnancy. During this embryonic phase, the spinal cord develops from a crack in the skin of the back. Normally, this fissure closes to form a tube, called the neural tube, which results in the development of the central nervous system and the spine. When this tube is closed, all the structures are perfectly protected inside the vertebral arches. After the first 6 weeks of pregnancy, the neural tube is normally completely closed. In case of incomplete closure of the neural tube, the spinal cord and nerve pathways are exposed and can therefore be damaged. This situation can lead to various medical, neurological and cognitive problems.. These include motor problems (due to impaired functioning of the leg muscles), sensory disturbances in the legs, bladder and bowel disorders, and curvature of the spine. In addition, spina bifida can also be accompanied by hydrocephalus (excessive accumulation of fluid in the brain), malformation of the cerebellum, learning disabilities and malformations of the feet. However, the severity of spina bifida symptoms varies depending on the form of the disease. Thus, spina bifida occulta, or “hidden” (the anomaly is covered by normal skin) is a mild form that causes no discomfort in most patients. In spina bifida aperta (the most severe form), the meninges surrounding the spinal cord and, in some cases, the spinal cord itself, come out of the spinal canal (back), and these structures are then no longer protected by the skin. Spina bifida affects girls slightly more often than boys.
WHAT ARE THE CAUSES OF SPINA BIFIDA?
Although the precise cause is not known, various risk factors have been identified that contribute to the development of spina bifida. Thus, hereditary and environmental factors may play a role. For example, folic acid deficiency during the first weeks of pregnancy can be one of the causes of spina bifida. Similarly, the use of certain medications during pregnancy, such as sodium valproate and carbamazepine, or the presence of diabetes, increase the risk of giving birth to a child with spina bifida. In addition, future mothers whose family includes a child with spina bifida also have an increased risk of giving birth to a child with this condition. Your doctor or gynecologist can give you more detailed information in this regard.
IS THERE A TREATMENT?
Depending on the type of spina bifida (aperta or occulta), different treatments can be considered. In the form of spina bifida aperta, a neurosurgical closure is usually performed as early as the first week after birth (even, often, during the first 24 hours) in order to prevent any infection of the meninges and spinal cord. Hydrocephalus is treated with a drain. Subsequently, and depending on the severity of the malformation, orthopedic interventions, rehabilitation/physiotherapy treatment and management of micturition disorders and constipation can considerably improve the child’s quality of life. With the treatment options currently available,the life expectancy of children with spina bifida has increased considerably: 9 children out of 10 exceed the age of 1 year, and 8 children out of 10 reach adulthood. Children with spina bifida can experience disabilities throughout their lives. These disabilities depend on the type of spina bifida and its severity. The more the spina bifida is located on the upper part of the back, the greater the handicaps will be.
REDUCED RISK OF SPINA BIFIDA
Taking 0.4 mg of folic acid daily as a preventive measure can reduce the risk of having a child with spina bifida or another neural tube defect by at least 50%. To do this, start taking your supplement every day, at least 1 month before stopping your contraception and until the 12th week of your pregnancy.
DO YOU HAVE QUESTIONS ABOUT FOLIC ACID AND ITS USE BEFORE AND DURING YOUR PREGNANCY?
Do not hesitate to contact your doctor or pharmacist!