Materiały źródłowe

• #1 Spina Bifida Prevention: A Narrative Review of Folic Acid Supplements for Childbearing Age Women

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10894015/

  Neural tube defects (NTDs) are malformations that occur during embryonic development, and they account for most central nervous system birth anomalies. […] Prevention of NTDs by administration of folic acid has been studied and described in the literature, yet there are approximately 300,000 cases of NTDs that occur annually, with 88,000 deaths occurring per year worldwide. A daily intake of at least 400 g of folic acid is recommended especially for women of childbearing age. […] The prevention of NTDs by administration of folic acid has been studied and discussed in the literature. On an international level, at least 400 g of folic acid has been recommended in the first month before conception and throughout the first trimester. […] The primary medical approach to NTDs, including spina bifida, is prevention via a recommended dietary supplementation of folate (e.g., folic acid, vitamin B9) for women of childbearing age. Folic acid supplementation has been described to reduce the incidence rate of NTDs because of its major contributions to cell proliferation and neurulation.

• #1 Spina Bifida: Types, Tests, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/8719-spina-bifida

  Even though there is no known cause, experts believe spina bifida can be avoided with some simple measures to follow: […] Folic acid, a water-soluble B vitamin often found in leafy green vegetables, plays an important role in the prevention of spina bifida. During childbearing years, women should take a vitamin with 400 mcg (0.4 mg) folic acid every day. Some studies suggest that if women take this dosage of folic acid the incidence of spina bifida could be reduced by up to 75%. […] Tell your healthcare provider if you are taking any prescription and over-the-counter drugs, herbal and dietary supplements and vitamins. […] Treat any fevers immediately with store brand acetaminophen or its brand name Tylenol. […] Avoid using hot tubs or saunas that overheat your body. […] If you have diabetes or obesity, be sure to do your best to manage these conditions while you’re pregnant.

• #1 Preventing Spina Bifida in Children | NYU Langone Health

  https://nyulangone.org/conditions/spina-bifida-in-children/prevention

  Even though the cause of spina bifida is unclear, a large body of evidence suggests that a woman who plans to become pregnant can dramatically reduce the risk of having a child with the condition by ensuring she gets enough folic acid. […] Doctors recommend that women who are planning to have a baby start taking 400 micrograms of folic acid every day for at least three months before trying to become pregnant. Women should continue to take folic acid daily throughout pregnancy. […] If spina bifida runs in your family and you are pregnant or planning to become pregnant, your doctor may prescribe a 4,000-microgram dose of folic acid to reduce the risk of having a child with the condition.

• #1 Spina bifida – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/spina-bifida/symptoms-causes/syc-20377860

  You can greatly reduce your risk of having a baby with spina bifida or other neural tube defects by taking folic acid supplements. Begin taking the supplements at least one month before becoming pregnant and continue taking them through the first trimester of pregnancy. […] Having enough folic acid in your body by the early weeks of pregnancy is critical to prevent spina bifida. But many people don’t discover that they’re pregnant until this time. For this reason, experts recommend that all people of childbearing age take a supplement of 400 micrograms (mcg) of folic acid a day. […] Adults who are planning pregnancy or who could become pregnant need to get 400 to 800 mcg of folic acid a day. […] If you have spina bifida or if you’ve previously given birth to a child with spina bifida, you need extra folic acid before you become pregnant. If you’re taking anti-seizure medicines or you have diabetes, you also may benefit from a higher dose of this B vitamin. Check with your healthcare professional before taking additional folic acid supplements.

• #1

  https://www.nhs.uk/conditions/spina-bifida/

  The best way to prevent spina bifida is to take folic acid supplements before and during pregnancy. […] You should take a 400 microgram folic acid tablet every day while you’re trying to get pregnant and until you’re 12 weeks pregnant. […] If you did not take folic acid before you conceived, you should start as soon as you find out you’re pregnant. […] Women thought to be at higher risk of having a child with spina bifida need to be prescribed a higher (5 milligram) dose of folic acid by a GP. […] A GP can advise you further about this. […] If you’re taking medicine to treat epilepsy, you should ask your GP for advice. You may also need to take a higher dose of folic acid.

• #1 What is Spina Bifida? Resources and Prevention – Spina Bifida Associationheaderheader-color

  https://www.spinabifidaassociation.org/what-is-spina-bifida/

  While there is no known cause, it has been shown that women who are old enough to have babies should take folic acid before and during the first three months of pregnancy. Because half of the pregnancies in the United States are unplanned, the Spina Bifida Association asks women to take a vitamin with 400 mcg (0.4 mg) of folic acid each day during the years of their lives when they are possibly able to have children. […] Additionally, women who have a child or sibling with Spina Bifida, have had an affected pregnancy, or have Spina Bifida themselves should take 4000 mcg (4.0 mg) of folic acid for one to three months before and during the first three months of pregnancy. Research shows the likelihood of having a second baby with Spina Bifida is about three percent. It’s important to know that neural tube defects like Spina Bifida are not entirely understood, and Spina Bifida is not something that is caused by the actions of the parents. It is recommended that adults with Spina Bifida and couples who already have a child with Spina Bifida talk with their OB-GYN or genetic counselor about their risk factors and ways to reduce the risk.

• #1

  https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5113a1.htm

  In September 1992, the U.S. Public Health Service (USPHS) recommended that all women capable of becoming pregnant should consume 400 g of folic acid/day on an ongoing basis to reduce their risk for having a pregnancy affected by spina bifida and anencephaly (i.e., neural tube defects [NTDs]) […] The 1991 CDC recommendation stated that women at high risk should plan subsequent pregnancies and consume 4,000 g/day of folic acid from the time they begin trying to become pregnant through the first trimester of pregnancy to reduce their risk […] Both of these recommendations were based on scientific evidence that increased folic acid consumption reduced the risk for having a pregnancy affected by an NTD. […] The 1992 USPHS recommendation stated that increased folic acid consumption could be achieved in three ways: by increasing consumption of foods rich in naturally occurring folates, by increasing use of folic acid-containing dietary supplements, and by fortification of a staple foodstuff (e.g., flour).

• #1 Data and Statistics | Spina Bifida | CDC

  https://www.cdc.gov/spina-bifida/data/index.html

  Prevention efforts, like getting enough folic acid daily before and during early pregnancy, reduces the risk of spina bifida. […] Getting 400 micrograms (mcg) of folic acid daily before and during early pregnancy reduces the risk of neural tube defects (NTDs), including spina bifida. […] Effective 1998, the United States Food and Drug Administration (FDA) required that all grain products labeled 'enriched’ (breads, cereals) have folic acid added. This is known as folic acid fortification and had the goal of helping to reduce the risk of NTDs. […] Using data from 19 state-based birth defects tracking programs, scientists observed a 28% reduction in prevalence of NTDs before and after the introduction of folic acid fortification. […] Fortification has resulted in less severe spina bifida. Severity decreased by 70% when comparing studies published before and after fortification.

• #1 Neurosurgery addresses spina bifida prevention in Alabama’s Hispanic community – Neurosurgery

  https://www.uab.edu/medicine/neurosurgery/news-events/department-news/neurosurgery-addresses-spina-bifida-prevention-in-alabama-s-hispanic-community

  Neurosurgery addresses spina bifida prevention in Alabamas Hispanic community. […] Corn Masa Flour Stock Michael Feldman, M.D., a pediatric neurosurgery fellow in the University of Alabama at Birmingham Department of Neurosurgery Division of Pediatric Neurosurgery, is leading efforts to reduce spina bifida rates in Alabama’s Hispanic community through folic acid fortification of corn masa flour. […] An estimated 50% to 70% of NTDs are folic acid sensitive, meaning that adequate maternal folic acid intake before and during early pregnancy can have a significant impact in decreasing the occurrence of these defects, including spina bifida. […] However, corn masa flour, a staple in the Hispanic diet, was excluded from this mandate, leaving a significant gap in preventive health measures for the Hispanic community.

• #1

  https://www.nhs.uk/conditions/spina-bifida/causes/

  Not having enough folic acid during pregnancy is one of the most important factors that can increase your chances of having a child with spina bifida. […] It’s estimated that taking folic acid supplements before you conceive and while you’re pregnant may prevent up to 7 out of 10 cases of neural tube defects, such as spina bifida. […] If you have a family history of spina bifida, it’s very important that you take high-dose folic acid, prescribed by a GP before you become pregnant, and for at least the first 12 weeks of pregnancy. […] It’s advisable to use a reliable form of contraception if you need to take one of these medicines and are not trying to get pregnant. […] Tell your doctor if you’re thinking about trying for a baby and you need to take one of these medicines. They may be able to lower the dose and prescribe folic acid supplements at a higher than normal dose, to reduce the risk of problems.

• #1 Neural Tube Defects (NTDs): What They Are, Causes & Prevention

  https://my.clevelandclinic.org/health/diseases/22656-neural-tube-defects-ntd

  Folate (folic acid) deficiency before and during pregnancy increases the risk of having a baby with spina bifida and other NTDs. If you’re pregnant or thinking of becoming pregnant, it’s important to take prenatal vitamins to ensure you’re getting enough folate (folic acid) and other nutrients to support a healthy pregnancy. The Centers for Disease Control and Prevention (CDC) recommends all women who can become pregnant take 400 micrograms (mcg) of folic acid every day, in addition to eating food with folate, to help prevent NTDs. […] Any woman can have a baby with a neural tube defect (NTD). But certain factors make you more likely to have a baby with an NTD, including: […] Folate (folic acid) deficiency: Folate, the natural form of vitamin B-9, is important for healthy fetal development. A folate deficiency before and during pregnancy increases the risk of having a baby with spina bifida and other NTDs. […] If you take antiseizure medication or opioids, it’s important to talk to your healthcare provider before becoming pregnant about how these medications could affect your pregnancy and the likelihood of having a child with an NTD.

• #1 Spina Bifida Treatment & Management: Approach Considerations, Bladder Management, Bowel Management

  https://emedicine.medscape.com/article/311113-treatment

  The US Preventive Services Task Force recommendation remains 400-800 mcg of folic acid supplementation daily in all persons who are planning to become pregnant or who could become pregnant. […] For women who have spina bifida or have had a previous pregnancy with a neural tube defect, the American Academy of Pediatrics recommends 4 mg (4000 mcg) per day of folic acid supplementation. […] However, the metabolism of folic acid appears to be abnormal in affected patients, suggesting that spina bifida may result from an inherited defect rather than strictly from a deficiency. […] Improved understanding of the genetic factors involved in spina bifida could better allow its prevention.

• #1 Arsenic modifies the effect of folic acid in spina bifida prevention, a large hospital-based case-control study in Bangladesh | Environmental Health | Full Text

  https://ehjournal.biomedcentral.com/articles/10.1186/s12940-024-01091-1

  Spina bifida, a developmental malformation of the spinal cord, is associated with high rates of mortality and disability. Although folic acid-based preventive strategies have been successful in reducing rates of spina bifida, some areas continue to be at higher risk because of chemical exposures. […] Folic acid supplement use reduces the risk of spina bifida, and fortification of staple foods with folic acid has been successful in decreasing spina bifida rates in multiple countries. […] Our previous study discovered that higher water arsenic concentrations reduced the effectiveness of folic acid in spina bifida prevention. […] Our study found that arsenic modifies the effect of folic acid on spina bifida prevention in a population in Bangladesh, a country with high arsenic exposures through contaminated drinking water. Among mothers with toenail arsenic concentrations below the median, folic acid was associated with a protective effect, but a protective effect was not observed among mothers with toenail concentrations above the median.

• #1 Spina Bifida: Types, Treatments, and Symptoms

  https://www.healthline.com/health/spina-bifida

  Spina bifida occurs very early in pregnancy. Most women dont even know theyre pregnant by the time it occurs. So if youre trying to become pregnant, you should start taking preventive measures against spina bifida. Follow these preventive steps: […] Take a folic acid supplement as prescribed by your doctor. […] Include leafy green vegetables, nuts, beans, and other foods that contain folic acid in your diet. […] Discuss any medications or supplements you take with your doctor. […] If you have diabetes, make sure its under control prior to pregnancy. […] If youre overweight, you should talk to your doctor about a healthy diet and exercise plan. […] Keep your body from overheating from saunas, hot tubs, or a fever.

• #1 Spina Bifida Prevention Tips – Klarity Health Library

  https://my.klarity.health/spina-bifida-prevention-tips/

  If you are at high risk, with a family history of NTDs, you may be advised to take a higher dose folic acid while planning your pregnancy, whilst women who are not considered at risk should usually take a regular dose instead. […] Prenatal check-ups […] Depending on the situation, it is possible to detect if your baby is at risk of spina bifida before birth with screening examinations, such as: Alpha-Fetoprotein Test (AFP): A blood test taken around 16-18 weeks of gestation that aims to check levels of the alpha-fetoprotein in the mother. Higher levels of this protein maybe associated with spina bifida in the foetus. […] Maintain a balanced diet […] Diabetes and obesity are correlated to a higher risk of developing spina bifida. Therefore, eating a healthy diet to control blood sugar levels and calorie intake, and maintaining a healthy weight would help prevent the development of neurological disorders in your baby.

• #1 Spina Bifida | Brown University Health

  https://www.brownhealth.org/centers-services/fetal-treatment-program-new-england/conditions-we-treat/spina-bifida

  Fetal surgery to treat spina bifida was not available until recently and our program is the first in the region to offer it. In 2011, a study published in the New England Journal of Medicine showed that in most cases, fetal surgery was able to stop CSF from leaking and correct the Chiari-II malformation. The percentage of affected toddlers walking without assistance at age two and a half was 42 percent when treated with fetal surgery, compared with 21 percent for those treated after birth. The study also showed that fetal surgery reduces the chances of requiring a shunt to correct hydrocephalus. […] Not all patients qualify for, or would benefit from, this treatment. The operation must be performed early enough in pregnancy (typically around 25 to 26 weeks) to be truly effective. The most common complication for the fetus is prematurity: any major surgical intervention on the uterus and the fetus increases the risk of rupturing the membranes and thereby early delivery, sometimes very prematurely.

• #1 Spina Bifida Prevention: A Narrative Review of Folic Acid Supplements for Childbearing Age Women – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38406082/

  Neural tube defects (NTDs) are malformations that occur during embryonic development, and they account for most central nervous system birth anomalies. […] Prevention of NTDs by administration of folic acid has been studied and described in the literature, yet there are approximately 300,000 cases of NTDs that occur annually, with 88,000 deaths occurring per year worldwide. A daily intake of at least 400 g of folic acid is recommended especially for women of childbearing age. […] Women’s knowledge and awareness of folic acid regarding its importance in the prevention of spina bifida is a major factor in reducing incidence worldwide.

• #1 Health groups call for accelerated spina bifida and hydrocephalus prevention and care worldwide

  https://www.eu-patient.eu/Members/Weekly-Mailing/PUSH-global-alliance/

  In observance of World Birth Defects Day which took place on March 3rd, an international group of organisations working together on spina bifida and hydrocephalus called on the public and policy makers to take action to prevent these serious birth defects. […] PUSH! also called on governments around the world to fortify food items with the B vitamin folic acid, which can reduce the incidence of spina bifida and other serious birth defects of the brain and spine known as neural tube defects (NTDs). […] Health experts in the United States and other countries also recommend that all women of childbearing age take a daily multivitamin containing at least 400 micrograms of folic acid to prevent NTDs.

• #1 Center for Spina Bifida Prevention

  https://sph.emory.edu/departments/epi/research/centers/spina-bifida/index.html

  The Center for Spina Bifida Prevention (CSBP) is working to prevent spina bifida and other neural tube defects through widespread fortification of food with folic acid. […] CSBP’s mission is to preventing every possible folic acid-preventable neural tube defect around the world. […] The center brings a unique approach focused on prevention, directing its attention to capturing the political will to mandate fortification of foods with folic acid, a B vitamin that has been proven to prevent spina bifida and anencephaly. […] The center provides technical support to country partners to strengthen the design, implementation, and monitoring of mandatory cereal grain fortification processes and integrates these programs into the existing government and milling systems to make prevention sustainable.

• #1 Spina Bifida Prevention and Future Pregnancies – Children’s Hospital of Orange County

  https://choc.org/orthopaedics/neuromuscular-disease-program/spina-bifida-clinic/spina-bifida-prevention-future-pregnancies/

  Parents who have given birth to a child with spina bifida or other ONTD may have genetic counseling recommended by their physician to discuss the risk of recurrence in a future pregnancy, as well as vitamin therapy (a prescription for folic acid) that can decrease the recurrence risk for ONTD. Supplemental folic acid, a B vitamin, if taken one to two months prior to conception and throughout the first trimester of pregnancy, has been found to decrease the reoccurrence of ONTDs for couples who have had a previous child with an ONTD.

• #1 Raising awareness of spina bifida

  https://blogs.bcm.edu/2022/08/04/from-the-labs-raising-awareness-of-spina-bifida/

  Spina bifida is the most common birth defect of the central nervous system and the second most common of all structural birth defects. […] We need more research into the causes of this life-long condition to improve its prevention and treatment. […] Folic acid supplementation is considered one of the most significant public health breakthroughs in recent years. […] By providing mandatory folic acid fortification, as 87 countries, including the U.S. have done since 1998, we can prevent the vast majority of neural tube defect cases. […] Since prevention efforts fall short of our desire to prevent all preventable birth defects, we must consider novel approaches to managing pregnancies to reduce the number of affected infants. […] My lab is all about preventing preventable diseases by studying both pharmaceutical and environmental compounds, as well as genetic factors that contribute to the burden of birth defects.

• #2 Spina Bifida Prevention: A Narrative Review of Folic Acid Supplements for Childbearing Age Women – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38406082/

  Neural tube defects (NTDs) are malformations that occur during embryonic development, and they account for most central nervous system birth anomalies. […] Prevention of NTDs by administration of folic acid has been studied and described in the literature, yet there are approximately 300,000 cases of NTDs that occur annually, with 88,000 deaths occurring per year worldwide. A daily intake of at least 400 g of folic acid is recommended especially for women of childbearing age. […] Women’s knowledge and awareness of folic acid regarding its importance in the prevention of spina bifida is a major factor in reducing incidence worldwide.

• #2 What people with open spina bifida need to know about folic acid – Shine

  https://www.shinecharity.org.uk/sex-and-pregnancy/what-people-with-open-spina-bifida-need-to-know-about-folic-acid

  Folic acid, also known as vitamin B9, plays an important role in helping to prevent congenital conditions, including spina bifida. […] Folic acid helps the neural tube to form correctly and significantly reduces the chance of neural tube defects (NTDs), and this does include open spina bifida. […] Folic acid can help prevent around 70% of these tragedies from occurring. […] If you have open spina bifida and are planning to start a family, and opt to try to prevent NTD affecting your baby, you should start taking a 5 mg supplement daily for at least two months before trying for a baby. […] Folic acid’s potential to help prevent not only spina bifida but also anencephaly demonstrates its importance in pregnancy preparation.

• #2 What is Spina Bifida? Resources and Prevention – Spina Bifida Associationheaderheader-color

  https://www.spinabifidaassociation.org/what-is-spina-bifida/

  While there is no known cause, it has been shown that women who are old enough to have babies should take folic acid before and during the first three months of pregnancy. Because half of the pregnancies in the United States are unplanned, the Spina Bifida Association asks women to take a vitamin with 400 mcg (0.4 mg) of folic acid each day during the years of their lives when they are possibly able to have children. […] Additionally, women who have a child or sibling with Spina Bifida, have had an affected pregnancy, or have Spina Bifida themselves should take 4000 mcg (4.0 mg) of folic acid for one to three months before and during the first three months of pregnancy. Research shows the likelihood of having a second baby with Spina Bifida is about three percent. It’s important to know that neural tube defects like Spina Bifida are not entirely understood, and Spina Bifida is not something that is caused by the actions of the parents. It is recommended that adults with Spina Bifida and couples who already have a child with Spina Bifida talk with their OB-GYN or genetic counselor about their risk factors and ways to reduce the risk.

• #2 Spina bifida – Wikipedia

  https://en.wikipedia.org/wiki/Spina_bifida

  Most cases of spina bifida can be prevented if the mother gets enough folate before and during pregnancy. […] Adding folic acid to flour has been found to be effective for most women. […] Folate supplementation prior to conception has been found to reduce the risk of neural tube defects, including spina bifida, by 70%. […] Sources of folic acid include whole grains, fortified breakfast cereals, dried beans, leaf vegetables and fruits. […] Folate fortification of enriched grain products has been mandatory in the United States since 1998. This prevents an estimated 600 to 700 incidents of spina bifida a year in the U.S. and saves $400-600 million in healthcare expenses. […] The U.S. Food and Drug Administration, Public Health Agency of Canada and the UK Department of Health and Social Care (DHSC) recommended amount of folic acid for women of childbearing age and women planning to become pregnant is at least 0.4 mg/day of folic acid from at least three months before conception, and continued for the first 12 weeks of pregnancy.

• #2 Spina Bifida Treatment & Management: Approach Considerations, Bladder Management, Bowel Management

  https://emedicine.medscape.com/article/311113-treatment

  The US Preventive Services Task Force recommendation remains 400-800 mcg of folic acid supplementation daily in all persons who are planning to become pregnant or who could become pregnant. […] For women who have spina bifida or have had a previous pregnancy with a neural tube defect, the American Academy of Pediatrics recommends 4 mg (4000 mcg) per day of folic acid supplementation. […] However, the metabolism of folic acid appears to be abnormal in affected patients, suggesting that spina bifida may result from an inherited defect rather than strictly from a deficiency. […] Improved understanding of the genetic factors involved in spina bifida could better allow its prevention.

• #2 Spina bifida – Wikipedia

  https://en.wikipedia.org/wiki/Spina_bifida

  The United States Preventive Services Task Force (USPSTF) recommends all people who may become pregnant or are attempting pregnancy take a folic acid supplement containing 0.4-0.8 mg (400-800 mcg) of folic acid daily. […] Women who have already had a baby with spina bifida or other type of neural tube defect, or are taking anticonvulsant medication, should take a higher dose of 4-5 mg/day.

• #2 Exploring Spina Bifida: Symptoms, Diagnosis, and Prevention

  https://nararavalleymedical.com.au/2023/10/01/exploring-spina-bifida-symptoms-diagnosis-and-prevention/

  A deficiency of folate is an established risk factor for developing neural tube defects. To reduce the risk of spina bifida, its important to get enough folate in your diet. […] Folate is the naturally occurring form of vitamin B9 in food. One of the best sources of folate is green leafy vegetables such as spinach and lettuce. Other sources are avocadoes, asparagus, and Brussels sprouts. […] Many breakfast cereals, packaged foods, flour, and kinds of milk have folic acid added so getting enough should be easy. Take a supplement if youre unsure. The recommended amount is 400 micrograms per day.

• #2 CENTER FOR SPINA BIFIDA PREVENTION – EMORY UNIVERSITY

  https://preventspinabifida.org/

  Our mission: To prevent spina bifida by providing decision-makers with compelling, actionable scientific evidence for implementing food fortification with folic acid. […] The prevention of Spina Bifida is Simple, Affordable and Proven. The predominant cause of spina bifida and anencephaly is a lack of adequate folic acid (vitamin B9) in the mothers diet prior to conception and during the first month of pregnancy. […] Each year, about 200,000 children worldwide are born with folic acid-preventable spina bifida or anencephaly. A total of 58 countries are preventing these birth defects through sustained mandatory folic acid fortification, but more than 100.

• #2 Neurosurgery addresses spina bifida prevention in Alabama’s Hispanic community – Neurosurgery

  https://www.uab.edu/medicine/neurosurgery/news-events/department-news/neurosurgery-addresses-spina-bifida-prevention-in-alabama-s-hispanic-community

  To address this disparity, Feldman has collaborated with various organizations, including the March of Dimes, the Hispanic and Immigrant Center of Alabama (HICA!), and Alabama Arise, to form action groups advocating for legislative change. […] These groups are working diligently to draft and promote bills that would mandate the fortification of corn masa flour in Alabama. […] Feldman is working with UnidosUS, the nations largest Latino nonprofit advocacy organization, and Alabama Senators Katie Britt and Tommy Tuberville to advocate for federal policies. […] The potential impact of these legislative efforts, that could be implemented within two to five years, is profound. Mandating folic acid fortification in corn masa flour could prevent 30 to 120 cases of spina bifida annually in the Hispanic community, saving millions in healthcare costs and improving quality of life for affected families. […] Fortification is a cost-effective and straightforward solution that can save lives and reduce healthcare expenses, said Feldman. […] „Neurosurgeons can leverage their expertise to influence policy and advocate for patient needs,” Feldman emphasized.

• #2 Neural Tube Defects (NTDs): What They Are, Causes & Prevention

  https://my.clevelandclinic.org/health/diseases/22656-neural-tube-defects-ntd

  Folate (folic acid) deficiency before and during pregnancy increases the risk of having a baby with spina bifida and other NTDs. If you’re pregnant or thinking of becoming pregnant, it’s important to take prenatal vitamins to ensure you’re getting enough folate (folic acid) and other nutrients to support a healthy pregnancy. The Centers for Disease Control and Prevention (CDC) recommends all women who can become pregnant take 400 micrograms (mcg) of folic acid every day, in addition to eating food with folate, to help prevent NTDs. […] Any woman can have a baby with a neural tube defect (NTD). But certain factors make you more likely to have a baby with an NTD, including: […] Folate (folic acid) deficiency: Folate, the natural form of vitamin B-9, is important for healthy fetal development. A folate deficiency before and during pregnancy increases the risk of having a baby with spina bifida and other NTDs. […] If you take antiseizure medication or opioids, it’s important to talk to your healthcare provider before becoming pregnant about how these medications could affect your pregnancy and the likelihood of having a child with an NTD.

• #2 Arsenic modifies the effect of folic acid in spina bifida prevention, a large hospital-based case-control study in Bangladesh | Environmental Health | Full Text

  https://ehjournal.biomedcentral.com/articles/10.1186/s12940-024-01091-1

  Environmental arsenic exposure may reduce the protective effects of folic acid supplementation on spina bifida risk. Our findings raise important questions about the risk of spina bifida in arsenic-endemic areas and the effectiveness of folic acid supplements alone as the strategy to prevent spina bifida in high-arsenic areas of the world. Additional preventive measures, such as folic acid fortification of the food supply and reduction of arsenic exposure, may be needed to optimize spina bifida prevention in areas with high arsenic exposures.

• #2 Spina Bifida: Types, Tests, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/8719-spina-bifida

  Even though there is no known cause, experts believe spina bifida can be avoided with some simple measures to follow: […] Folic acid, a water-soluble B vitamin often found in leafy green vegetables, plays an important role in the prevention of spina bifida. During childbearing years, women should take a vitamin with 400 mcg (0.4 mg) folic acid every day. Some studies suggest that if women take this dosage of folic acid the incidence of spina bifida could be reduced by up to 75%. […] Tell your healthcare provider if you are taking any prescription and over-the-counter drugs, herbal and dietary supplements and vitamins. […] Treat any fevers immediately with store brand acetaminophen or its brand name Tylenol. […] Avoid using hot tubs or saunas that overheat your body. […] If you have diabetes or obesity, be sure to do your best to manage these conditions while you’re pregnant.

• #2 Spina Bifida Prevention Tips – Klarity Health Library

  https://my.klarity.health/spina-bifida-prevention-tips/

  If you are at high risk, with a family history of NTDs, you may be advised to take a higher dose folic acid while planning your pregnancy, whilst women who are not considered at risk should usually take a regular dose instead. […] Prenatal check-ups […] Depending on the situation, it is possible to detect if your baby is at risk of spina bifida before birth with screening examinations, such as: Alpha-Fetoprotein Test (AFP): A blood test taken around 16-18 weeks of gestation that aims to check levels of the alpha-fetoprotein in the mother. Higher levels of this protein maybe associated with spina bifida in the foetus. […] Maintain a balanced diet […] Diabetes and obesity are correlated to a higher risk of developing spina bifida. Therefore, eating a healthy diet to control blood sugar levels and calorie intake, and maintaining a healthy weight would help prevent the development of neurological disorders in your baby.

• #2 Spina Bifida | Brown University Health

  https://www.brownhealth.org/centers-services/fetal-treatment-program-new-england/conditions-we-treat/spina-bifida

  Fetal surgery to treat spina bifida was not available until recently and our program is the first in the region to offer it. In 2011, a study published in the New England Journal of Medicine showed that in most cases, fetal surgery was able to stop CSF from leaking and correct the Chiari-II malformation. The percentage of affected toddlers walking without assistance at age two and a half was 42 percent when treated with fetal surgery, compared with 21 percent for those treated after birth. The study also showed that fetal surgery reduces the chances of requiring a shunt to correct hydrocephalus. […] Not all patients qualify for, or would benefit from, this treatment. The operation must be performed early enough in pregnancy (typically around 25 to 26 weeks) to be truly effective. The most common complication for the fetus is prematurity: any major surgical intervention on the uterus and the fetus increases the risk of rupturing the membranes and thereby early delivery, sometimes very prematurely.

• #2 Spina Bifida | Brown University Health

  https://www.brownhealth.org/centers-services/fetal-treatment-program-new-england/conditions-we-treat/spina-bifida

  If the mother and fetus both qualify for fetal surgery, the mother will then be scheduled for multiple consultations to discuss the pros and cons of fetal surgery. She will meet with the high-risk obstetrician (maternal-fetal medicine specialist), fetal surgeons, pediatric neurosurgeon(s), an anesthesiologist who specializes in giving anesthesia to pregnant women, and a social worker. All of these consultations help educate the mother and help her make important decisions regarding her pregnancy and whether fetal surgery is the right option for her. […] If fetal surgery has been performed, the uterus is more fragile and Cesarean section is mandatory. If you opt to have the spina bifida repaired after birth, route of delivery (either vaginal or C-section) will be determined by your obstetrician. […] A newborn with spina bifida is at risk for severe infections and other complications, so it is recommended that mothers deliver in a center with immediate access to a specialized neonatal intensive care unit and immediate availability of pediatric neurosurgeons and pediatric plastic surgeons.

• #2 Spina Bifida Prevention Tips – Klarity Health Library

  https://my.klarity.health/spina-bifida-prevention-tips/

  Reducing the consumption of alcohol or even avoiding it completely would be advisable safe during pregnancy, this would eliminate one of the possible risk factors of spina bifida. […] Not all women are aware of the risk factors, especially when pregnancy occurs without consulting a healthcare professional first. Taking steps to improve general knowledge and education about this topic can help to lower the incidence of spina bifida, and a few other actions could work towards this goal: Promotion of public awareness campaigns. […] Prevention strategies, including prenatal vitamins, screening tests, and lifestyle adjustments, are crucial. Increasing awareness and access to healthcare through public campaigns and better collaboration among healthcare providers could significantly reduce the incidence of spina bifida.

• #2 STRATEGIC OBJECTIVES

  https://ifglobal.org/our-work/prevention/

  Improving national decision-makers access to knowledge about primary prevention of spina bifida and adult hydrocephalus […] The WHO Birth Defects Resolution, urged member states to increase their coverage of effective primary prevention measures (such as folic acid supplementation and/or fortification) and to develop expertise and build capacity on the prevention of birth defects. […] The IFGPI will help to support member states in developing national plans for implementation of effective interventions to prevent neural tube birth defects, including the development and delivery of effective folic acid awareness/prevention initiatives, education and food fortification strategies, in line with the aims of the World Health Organisation. […] The International Federation for Spina Bifida and Hydrocephalus (IF) is calling for urgent action demanding universal mandatory food fortification with vitamin B9 (folic acid) to reduce the risk of Spina Bifida, Anencephaly, or Encephalocele, also called Neural Tube Defects (NTDs).

• #2 Spina Bifida – AANS

  https://www.aans.org/patients/conditions-treatments/spina-bifida/

  Women of childbearing age can reduce their risk of having a child with spina bifida by taking 400 micrograms (mcg) of folic acid every day pre-conception. […] Research has shown that if all women of childbearing age took a multivitamin with the B-vitamin folic acid, the risk of neural tube defects could be reduced by up to 70%.

• #2 Spina Bifida

  https://www.pediatriconcall.com/articles/pediatric-neurology/spina-bifida/spina-bifida-treatment

  The best possible method for supplementation of folic acid in India described below: Eating folic acid foods and avoiding overcooking are already part of advice for healthy eating for the general population. […] We recommend that all women who are planning a pregnancy should be advised to take 400 micrograms of folic acid as a daily medicinal or food supplement from when they plan to have a baby until the twelfth week of pregnancy. […] This will be the most effective method of NTD prevention in India. […] Extra folate/folic acid is recommended for all women prior to conception and during the first twelve weeks of pregnancy. […] The three possible ways of achieving an extra intake of folate/folic acid (eating more folate-rich foods, eating foods fortified with folic acid, taking folic acid as a medicinal/food supplement). […] All women who are planning a pregnancy should be advised to take 0.4 milligrams (400 micrograms) folic as a daily medicinal or food supplement from when they begin trying to conceive until the twelfth week of pregnancy.

• #2 Spina Bifida Prevention: Essential Tips & Guide – Acibadem Health Point – ACIBADEM Hospitals – Acibadem Health Group

  https://www.acibademhealthpoint.com/spina-bifida-prevention-essential-tips-guide/

  Women who might get pregnant should get 400 micrograms (mcg) of folate each day. Pregnant women need at least 600 mcg. It’s good to talk to doctors about what you need. […] Eating foods high in folic acid helps a lot. Good foods are: Leafy greens like spinach, kale, and romaine lettuce; Citrus fruits such as oranges and grapefruits; Beans and legumes including lentils and chickpeas; Whole grains like brown rice and fortified cereals; Nuts and seeds such as sunflower seeds and almonds. […] When you’re pregnant, it’s very important to stay away from things that can hurt your baby. Things like some medicines, drugs, and alcohol can be bad for your baby. […] For couples with a family history of spina bifida, genetic counseling is key. It helps them learn about hereditary conditions and tests for spina bifida. This way, parents can make smart choices.

• #2 Can you reduce the risk of having a baby with spina bifida? | March of Dimes

  https://www.marchofdimes.org/find-support/blog/can-you-reduce-risk-having-baby-spina-bifida

  Spina bifida can be diagnosed during pregnancy or after your baby’s is born. There are steps you can take before and during pregnancy to help prevent spina bifida in your baby. […] Taking folic acid before and during early pregnancy can help prevent NTDs in your baby. If you have spina bifida or if you’ve had a baby or a pregnancy with an NTD, talk to your health care provider about how much folic acid you should take before getting pregnant again. […] Get to a healthy weight before pregnancy. […] Get treatment for health conditions like diabetes, a medical condition in which your body has too much sugar (called glucose) in your blood. […] Your provider may tell you to stop taking a medicine or switch you to one that’s safer during pregnancy. […] This may increase your chances of having a baby with spina bifida. Don’t use hot tubs or saunas when you’re pregnant.

• #2 How Folic Acid Prevents Spina Bifida | Action Medical Research

  https://action.org.uk/research/successes/folic-acid-spina-bifida-prevention

  Women trying to become pregnant are now routinely advised to take folic acid supplements to prevent spina bifida and the number of cases in the UK has dramatically reduced. […] Funding from Action in the 1980s supported the first small scale clinical study investigating if neural tube defects could be prevented by taking vitamin supplements in pregnancy. The positive results of this trial paved the way for larger clinical studies, leading to a major trial in 1991 funded by the Medical Research Council (MRC) that showed that folic acid can prevent spina bifida in up to seven out of ten cases. […] Today, women trying to become pregnant are routinely advised to take folic acid supplements.

• #3 Spina bifida – Wikipedia

  https://en.wikipedia.org/wiki/Spina_bifida

  Most cases of spina bifida can be prevented if the mother gets enough folate before and during pregnancy. […] Adding folic acid to flour has been found to be effective for most women. […] Folate supplementation prior to conception has been found to reduce the risk of neural tube defects, including spina bifida, by 70%. […] Sources of folic acid include whole grains, fortified breakfast cereals, dried beans, leaf vegetables and fruits. […] Folate fortification of enriched grain products has been mandatory in the United States since 1998. This prevents an estimated 600 to 700 incidents of spina bifida a year in the U.S. and saves $400-600 million in healthcare expenses. […] The U.S. Food and Drug Administration, Public Health Agency of Canada and the UK Department of Health and Social Care (DHSC) recommended amount of folic acid for women of childbearing age and women planning to become pregnant is at least 0.4 mg/day of folic acid from at least three months before conception, and continued for the first 12 weeks of pregnancy.

• #3 Spina Bifida – AANS

  https://www.aans.org/patients/conditions-treatments/spina-bifida/

  Women of childbearing age can reduce their risk of having a child with spina bifida by taking 400 micrograms (mcg) of folic acid every day pre-conception. […] Research has shown that if all women of childbearing age took a multivitamin with the B-vitamin folic acid, the risk of neural tube defects could be reduced by up to 70%.

• #3 Preventing spina bifida – UKRI

  https://www.ukri.org/who-we-are/how-we-are-doing/research-outcomes-and-impact/mrc/preventing-spina-bifida/

  In 2021, the UK government announced the introduction of mandatory fortification of non-wholemeal wheat flour with folic acid. […] They had found that folic acid supplementation for women around the time of conception reduced the risk of spina bifida and other serious neural tube defects (NTDs). […] The study authors firmly advised that the diet of all women who may bear children contain adequate folic acid, especially women who had had an affected pregnancy. […] Within weeks, the US Centers for Disease Control (CDC) recommended that women who had previously had an NTD pregnancy consume 4,000 micrograms of folic acid a day if planning a pregnancy. […] A year later, the CDC recommended that all women capable of pregnancy consume 400 micrograms of folic acid a day to prevent NTDs. […] Other countries followed with similar recommendations.

• #3 Raising awareness of spina bifida

  https://blogs.bcm.edu/2022/08/04/from-the-labs-raising-awareness-of-spina-bifida/

  Spina bifida is the most common birth defect of the central nervous system and the second most common of all structural birth defects. […] We need more research into the causes of this life-long condition to improve its prevention and treatment. […] Folic acid supplementation is considered one of the most significant public health breakthroughs in recent years. […] By providing mandatory folic acid fortification, as 87 countries, including the U.S. have done since 1998, we can prevent the vast majority of neural tube defect cases. […] Since prevention efforts fall short of our desire to prevent all preventable birth defects, we must consider novel approaches to managing pregnancies to reduce the number of affected infants. […] My lab is all about preventing preventable diseases by studying both pharmaceutical and environmental compounds, as well as genetic factors that contribute to the burden of birth defects.

• #3 Center for Spina Bifida Prevention

  https://sph.emory.edu/departments/epi/research/centers/spina-bifida/index.html

  The Center for Spina Bifida Prevention (CSBP) is working to prevent spina bifida and other neural tube defects through widespread fortification of food with folic acid. […] CSBP’s mission is to preventing every possible folic acid-preventable neural tube defect around the world. […] The center brings a unique approach focused on prevention, directing its attention to capturing the political will to mandate fortification of foods with folic acid, a B vitamin that has been proven to prevent spina bifida and anencephaly. […] The center provides technical support to country partners to strengthen the design, implementation, and monitoring of mandatory cereal grain fortification processes and integrates these programs into the existing government and milling systems to make prevention sustainable.

• #3 Spina Bifida Prevention Methods and Tips – Acibadem Health Point – ACIBADEM Hospitals – Acibadem Health Group

  https://www.acibademhealthpoint.com/spina-bifida-prevention-methods-and-tips/?amp=1

  Living a healthy life is also key for maternal health care. Eating right, exercising, and not using tobacco or alcohol helps. […] Prenatal check-ups keep an eye on mom and baby’s health. They let doctors check vital signs, watch the baby grow, and find early problems. […] For a healthy pregnancy, it’s important to avoid substances that can harm the baby. This means no alcohol, smoking, or certain medicines. […] Drinking alcohol while pregnant can hurt the baby a lot. It can cause serious problems like fetal alcohol syndrome. […] Smoking while pregnant can cause big problems. It can make the baby too small and increase the chance of some birth defects. […] Being around harmful toxins can raise the chance of spina bifida. It’s key to stay away from bad chemicals, especially when you’re pregnant.

• #3 Spina Bifida Prevention: Essential Tips & Guide – Acibadem Health Point – ACIBADEM Hospitals – Acibadem Health Group

  https://www.acibademhealthpoint.com/spina-bifida-prevention-essential-tips-guide/

  Women who might get pregnant should get 400 micrograms (mcg) of folate each day. Pregnant women need at least 600 mcg. It’s good to talk to doctors about what you need. […] Eating foods high in folic acid helps a lot. Good foods are: Leafy greens like spinach, kale, and romaine lettuce; Citrus fruits such as oranges and grapefruits; Beans and legumes including lentils and chickpeas; Whole grains like brown rice and fortified cereals; Nuts and seeds such as sunflower seeds and almonds. […] When you’re pregnant, it’s very important to stay away from things that can hurt your baby. Things like some medicines, drugs, and alcohol can be bad for your baby. […] For couples with a family history of spina bifida, genetic counseling is key. It helps them learn about hereditary conditions and tests for spina bifida. This way, parents can make smart choices.

• #3 Spina Bifida | Brown University Health

  https://www.brownhealth.org/centers-services/fetal-treatment-program-new-england/conditions-we-treat/spina-bifida

  If the mother and fetus both qualify for fetal surgery, the mother will then be scheduled for multiple consultations to discuss the pros and cons of fetal surgery. She will meet with the high-risk obstetrician (maternal-fetal medicine specialist), fetal surgeons, pediatric neurosurgeon(s), an anesthesiologist who specializes in giving anesthesia to pregnant women, and a social worker. All of these consultations help educate the mother and help her make important decisions regarding her pregnancy and whether fetal surgery is the right option for her. […] If fetal surgery has been performed, the uterus is more fragile and Cesarean section is mandatory. If you opt to have the spina bifida repaired after birth, route of delivery (either vaginal or C-section) will be determined by your obstetrician. […] A newborn with spina bifida is at risk for severe infections and other complications, so it is recommended that mothers deliver in a center with immediate access to a specialized neonatal intensive care unit and immediate availability of pediatric neurosurgeons and pediatric plastic surgeons.

• #3 Pediatric Neurology & Neurosurgery Program: Spina Bifida Treatment

  https://www.rwjbh.org/treatment-care/neuroscience/neurosurgery/conditions-treated/spina-bifida/

  Because spina bifida occurs during the first month of fetal development, it can be very difficult to successfully prevent it, as many women are unaware of their pregnancy at this stage. The American College of Medical Genetics and the Centers for Disease Control and Prevention (CDC) recommend that women of childbearing age, especially those actively trying to conceive, should take a multivitamin containing folic acid, which may prevent spina bifida. A healthy diet containing foods high in folic acid is also recommended. […] In recent years, pioneering neurosurgeons have used an experimental technique to correct spina bifida in utero with prenatal surgery in fetuses before the twenty-sixth week of gestation. This type of fetal surgery can successfully close the defect and prevent further loss of nerve function with better results than performing on a baby after birth. Prenatal surgery is not feasible in every patient, and this type of specialized surgery should only be performed by experienced fetal surgery experts using a multispecialty approach that involves neonatal intensive care.

• #3

  https://www.ajol.info/index.php/ajns/article/view/231956

  Spina bifida is caused by a neural tube defect (NTD). It is a severe congenital malformation that can be prevented by folic acid supplementation. […] Most of the respondents (96%) knew about spina bifida. 44 (57,9%) of them were aware of folic acid as a means of preventing spina bifida. […] The SFE and AAE in the Kozah health district did not know the recommendations for preventing spina bifida. Therefore, it would be desirable to organize continuous training for them in the prevention of spina bifida and NTD.

• #3 STRATEGIC OBJECTIVES

  https://ifglobal.org/our-work/prevention/

  Food fortification with folic acid is urgently needed to achieve the objectives of the 2010 World Health Assembly Resolution on Birth Defects and achieve the sustainable development goals (SDGs). […] Recognizing the 63rd World Health Assembly’s Resolution on Birth Defects that appealed to member states to prioritize prevention of birth defects, we are concerned by the high number of pregnancies affected by folic acid-preventable spina bifida and anencephaly globally.

• #3 Global Alliance Co-Founded by Children’s Neurosurgeon Affecting Change in Spina Bifida Prevention Effort – Inside Pediatrics

  https://insidepeds.org/2023/08/25/global-alliance-affecting-change-in-spina-bifida-prevention-effort/

  Spina bifida is the most frequently occurring permanently disabling birth defect to affect the nervous system. […] In 2019, he co-founded the Global Alliance for the Prevention of Spina Bifida, or GAPSBiF, an organization dedicated to increasing awareness and advocating for the prevention of SB through large-scale food fortification with folic acid (FA). Its already affecting change. […] One of the GAPSBiFs major strategies for preventing SB was working with other neurosurgical and nutrition directed organizations in putting together a resolution that called upon all World Health Assembly (WHA) member states to embrace micronutrient fortification including FA to prevent SB. […] This has real potential to favorably and fundamentally impact the global prevalence of SB and other micronutrient dependent diseases, Blount said. It is an essential step toward overcoming the stalled progress on the prevention of spina bifida.

• #3 Global Alliance Co-Founded by Children’s Neurosurgeon Affecting Change in Spina Bifida Prevention Effort – Inside Pediatrics

  https://insidepeds.org/2023/08/25/global-alliance-affecting-change-in-spina-bifida-prevention-effort/

  Nutritional shortage of FA in women of childbearing age is the most important contributor to SB prevalence worldwide. […] Fortifying widely consumed foods such as corn, grain or rice is more effective, which is why GAPSBiF works so hard to promote this strategy. […] GAPSBiFs approach is centered around prevention. Lets keep these little children from getting this terribly difficult disease, Blount said, because its lifelong. […] We know that if we can get folic acid into population food supplies, that up to 90% [of the SB cases worldwide] can be profoundly reduced, Blount said. […] Regulations for mandatory fortification of wheat flour with FA are currently in place in 60 countries, although in many cases, these regulations have not been implemented.

• #4 Neurosurgery addresses spina bifida prevention in Alabama’s Hispanic community – Neurosurgery

  https://www.uab.edu/medicine/neurosurgery/news-events/department-news/neurosurgery-addresses-spina-bifida-prevention-in-alabama-s-hispanic-community

  Neurosurgery addresses spina bifida prevention in Alabamas Hispanic community. […] Corn Masa Flour Stock Michael Feldman, M.D., a pediatric neurosurgery fellow in the University of Alabama at Birmingham Department of Neurosurgery Division of Pediatric Neurosurgery, is leading efforts to reduce spina bifida rates in Alabama’s Hispanic community through folic acid fortification of corn masa flour. […] An estimated 50% to 70% of NTDs are folic acid sensitive, meaning that adequate maternal folic acid intake before and during early pregnancy can have a significant impact in decreasing the occurrence of these defects, including spina bifida. […] However, corn masa flour, a staple in the Hispanic diet, was excluded from this mandate, leaving a significant gap in preventive health measures for the Hispanic community.

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