Folic Acid and Pregnancy

by CDC

The purpose of these questions and answers is to educate women of childbearing age on the importance of consuming 400 micrograms of folic acid every day. Folic acid can help reduce the risk of spina bifida by up to 70%.

What are neural tube defects (NTDs)?

Neural tube defects (NTDs) are major birth defects of a baby's brain or spine. They happen when the neural tube (that later turns into the brain and spine) doesn't form right, and the baby's brain or spine is damaged. This happens within the first few weeks a woman is pregnant, often before a woman knows that she is pregnant.

The two most common NTDs are spina bifida (spi-na bif-a-da) and anencephaly (an-en-sef-a-lee). These birth defects can cause lifelong disability or death. Many NTDs (up to 70%) can be prevented by getting enough of the B vitamin folic acid every day, starting before a woman gets pregnant.

What are spina bifida and anencephaly?

Spina bifida (spi-na bif-a-da) and anencephaly (an-en-sef-a-lee) are two common types of NTDs. About 3,000 pregnancies in the United States are affected by spina bifida or anencephaly each year. Many of these defects could be prevented if all women got enough of the B vitamin folic acid every day starting before they get pregnant.

Spina bifida occurs when the spine and back bones do not close all the way. When this happens, the spinal cord and back bones do not form as they should. A sac of fluid comes through an opening in the baby's back. Much of the time, part of the spinal cord is in this sac and it is damaged. Most children born with spina bifida live full lives, but they often have lifelong disabilities and need many surgeries. Some of their problems include: Not being able to move lower parts of their body. (Some might need to use crutches, braces, or wheelchairs to get around.) Loss of bowel and bladder control. (Some might have to wear protective clothing. Others learn new ways to empty their bladders and bowels.) Fluid building up and putting pressure on the brain (hydrocephalus), which needs to be fixed with an operation Learning disabilities. Allergy to latex (a created material found in some rubber-type products such as balloons or hospital gloves).

Children born with spina bifida don't all have the same needs. Some children's problems are much more severe than others. Even so, with the right care, most of these children will grow up to lead full and productive lives.

Anencephaly occurs when the brain and skull bones do not form right. When this happens, part or all of the brain and skull bones might be missing. Babies with this defect die before birth (miscarriage) or shortly after birth.

Who can have a baby with a neural tube defect in the United States?

Any woman in the United States can have a baby with an NTD. If a woman can get pregnant, she is at risk for having an NTD-affected pregnancy. No one can predict which women will have a pregnancy affected by an NTD. All women are at risk.

Some things can increase a woman's chance of having a baby with an NTD:

• Previous NTD-affected pregnancy.
• Diabetes when the blood sugar is out of control.
• Some medicines (like some of those that treat epilepsy).
• Obesity.
• High temperatures in early pregnancy (such as fever that lasts a while, or using hot tubs and saunas).
• Hispanic ethnicity (Hispanic women tend to have more babies affected by NTDs).

What are the costs linked with NTDs?

The average cost of caring for a child born with spina bifida for life is about $636,000.00 per child. This is only an average cost, and for many families the total cost might be well above $1,000,000. And it's not just the money. The physical and emotional tolls upon the families affected are high as well. That's why it's so important that women take folic acid every day to help prevent these birth defects.

What is folic acid and where can I get it?

Folic acid is a B vitamin that the body needs to make healthy new cells. If a woman has enough folic acid in her body before and during pregnancy, her baby is less likely to have an NTD. Women need to take folic acid every day, starting before they get pregnant.

Every woman who could possibly get pregnant should take 400 micrograms (400 mcg or 0.4 mg) of folic acid daily in a vitamin or in foods that have been enriched with folic acid.

About the Author

www.cdc.gov
The Centers for Disease Control and Prevention (CDC) is one of the 13 major operating components of the Department of Health and Human Services (HHS), which is the principal agency in the United States government for protecting the health and safety of all Americans and for providing essential human services, especially for those people who are least able to help themselves.