Neural Tube Defects, Such as Spina Bifida, on the Decline: CDC

Experts cite mandatory fortification of grain products with folic acid, but not enough women get the B vitamin

By Robert Preidt

Thursday, January 15, 2015

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THURSDAY, Jan. 15, 2015 (HealthDay News) -- Serious birth defects of the brain and spine called neural tube defects have fallen 35 percent in the United States since mandatory folic acid fortification of enriched grain products was introduced in 1998, federal officials reported Thursday.

That decrease means 1,300 fewer babies are born annually with neural tube defects such as spina bifida, the most common neural tube defect that, in severe cases, can cause partial or complete paralysis of the parts of the body below the waist.

However, even with folic acid fortification some women don't get enough of the B vitamin, especially Hispanic women, according to the U.S. Centers for Disease Control and Prevention (CDC).

The agency said all women of childbearing age -- even if they're not planning to get pregnant -- need to get 400 micrograms of folic acid daily from fortified foods, supplements, or both, and to eat foods high in folic acid.

"All women capable of having a baby should be taking a multivitamin containing folic acid every day," Dr. Siobhan Dolan, co-author of the March of Dimes bookHealthy Mom, Healthy Baby: The Ultimate Pregnancy Guide, said in a news release from the organization.

"It's also good to eat foods that contain folate, the natural form of folic acid, including lentils, green leafy vegetables, black beans and orange juice, as well as foods fortified with folic acid, such as bread and pasta, and enriched cereals," she added.

Another CDC study released Thursday found that many American women who had a pregnancy affected by a neural tube defect and get pregnant again don't follow folic acid supplement recommendations. Health-care providers need to do more to encourage these women to boost their folic acid intake, the study authors said.

Among women with a neural tube defect in a previous pregnancy, only 35 percent of those who had a neural tube defect in a second pregnancy took folic acid, compared with 80 percent of those with a birth defect-free pregnancy, the study found.

Women who've experienced a neural tube defect are at increased risk for another one, the researchers noted. It's known that high-dose folic acid supplements -- 4 milligrams a day taken at least four weeks before becoming pregnant and through the first 12 weeks of pregnancy -- reduce the risk of neural tube defects, the CDC said.

Hispanic women are about 20 percent more likely to have a child with a neural tube defect than non-Hispanic white women. One reason, according to the March of Dimes: wheat flour is fortified with folic acid, but corn masa flour -- which is more popular among Hispanics -- is not fortified.

The March of Dimes says it has asked the U.S. Food and Drug Administration to fortify corn masa flour with folic acid with the goal of lowering the rate of neural tube defects among Hispanic women.

Both studies appear in the Jan. 16 issue of Morbidity and Mortality Weekly Report, published by the CDC.

SOURCES: Jan. 16, 2015, Morbidity and Mortality Weekly Report, U.S. Centers for Disease Control and Prevention; Jan. 15, 2015, news release, March of Dimes, White Plains, N.Y.

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