Spina Bifida: Effects, Risks, Diagnosis, and Prevention
Spina bifida is a neural tube defect that affects approximately 1,500 pregnancies each year. Although the occurrences appear to be decreasing, the birth defect occurs in approximately 7 of out every 10,000 live births in the United States. According to the Spina Bifida Association of America, it is estimated that more than 70,000 people in the United States are living with this birth defect.
What is spina bifida?
Spina bifida is a neural tube defect that develops during the first month of pregnancy when the spinal column does not close completely.
What are the effects of spina bifida?
The effects may be different for every person. Up to 90% of children with the worst form of spina bifida have hydrocephalus (fluid on the brain) and must have surgery to insert a “shunt” that helps drain the fluid—the shunt stays in place for the lifetime of the person.
Other conditions include full or partial paralysis, bladder and bowel control difficulties, learning disabilities, depression, social and sexual issues, and latex allergy.
Who is at risk?
Every pregnant woman is at risk for a possible birth defect. In fact, 95% of neural tube defects (NTDs) occur in women with no personal or family history of NTDs.
However, according to the Centers for Disease Control and Prevention (CDC), here are some risk factors that are known to increase the risk of an NTD:
- A previous NTD-affected pregnancy makes it approximately 20x more likely that a woman will have another NTD-affected pregnancy
- Maternal insulin-dependent diabetes
- Use of certain anti-seizure medication (Valproic acid/Depakene, and Carbamazepine/Tegretol)
- Medically diagnosed obesity
- High temperatures in early pregnancy (i.e., prolonged fevers and hot tub use)
- Race/ethnicity (NTDs are more common among white women than black women, and more common among Hispanic women than non-Hispanic women)
- Lower socioeconomic status
How is it diagnosed?
Spina bifida is one of several birth defects that is first screened for using either the AFP or triple test. High levels of alpha-fetoprotein is a sign of potential neural tube defects and warrant further testing. Keep in mind that there are between 50 and 100 abnormally high AFP results in 1,000 pregnancies when in actuality there are only 1 to 2 babies affected with a neural tube defect.
If screening identifies potential NTDs, spina bifida may be further diagnosed using a procedure known as amniocentesis.
How can you prevent it?
Spina bifida is best prevented by taking 400 micrograms (mcg) of folic acid every day. Studies have shown that if all women who could become pregnant were to take a multivitamin with the B-vitamin folic acid, the risk of neural tube defects could be reduced by up to 70%.
Folic acid is a water-soluble B-vitamin that helps build healthy cells, but it does not stay in the body long. It is important that women take folic acid every day to help reduce the risk of neural tube defects.
Since half of all pregnancies in the United States are unplanned, women of childbearing age – even if they are not currently planning to get pregnant – should take 400 micrograms (mcg) of folic acid every day to reduce their risk of having a child with spina bifida.
What if you are at a higher risk for spina bifida?
Women who have experienced a pregnancy affected by an NTD like spina bifida need a higher intake of folic acid. It is suggested that these women need to take a dose that is 10 times greater when planning a pregnancy. This amount of folic acid is 400 micrograms (mcg) and is available by prescription from a health care provider.
Where can I go for additional information?
For additional information contact the Spina Bifida Association of America:
Spina Bifida Association of America
4590 MacArthur Blvd., NW, Suite 250
Washington, DC 20007-4226
Centers for Disease Control and Prevention. Prevalence of Spina Bifida at Birth — the United States, 1983-1990: a Comparison of Two Surveillance Systems, MMWR Morbidity, and Mortality Weekly Report. 1996; 45: SS02;015.
Centers for Disease Control and Prevention. Use of Folic Acid for Prevention of Spina Bifida and Other Neural Tube Defects 1983-1991. MMWR Morbidity and Mortality Weekly Report. 1991;40:513-516. CDC, 1999. https://www.cdc.gov/mmwr/preview/mmwrhtml/00014915.htm, accessed Aug 7, 2002.
Centers for Disease Control and Prevention. Use of Folic Acid for Prevention of Spina Bifida and Other Neural Tube Defects 1983-1991. MMWR Morbidity and Mortality Weekly Report. 1991;40:513-516.
Centers for Disease Control and Prevention. Prevalence of Spina Bifida at the Birth United States, 1983-1990: a Comparison of Two Surveillance Systems, MMWR Morbidity, and Mortality Weekly Report. 1996; 45: SS02;015.