Introduction
Neuro tubular defects or neural tube defects (NTDs) are severe birth abnormalities caused by incomplete closure of the fetal neural tube. This tube normally forms the brain and spinal cord. Unfortunately, this crucial development happens within just 28 days of conception—often before pregnancy is detected.
The most common NTDs are spina bifida (incomplete spine closure) and anencephaly (missing brain/skull parts). Both can cause lifelong disabilities or death, making prevention vital.
Thankfully, NTD risk drops dramatically with folic acid. This B-vitamin supports DNA and cell growth, especially during early pregnancy. In this article, we would discuss how to prevent neural tube defect with folic acid.
Relevant Statistics of Neurotubular Defects
NTDs affect approximately 1 in 1,000 live births worldwide. Supported by global estimates from the WHO and studies noting a range of 0.3–199.4 per 10,000 births (median 6.9–35.9 in high-income regions). A 2016 meta-analysis reported a global median prevalence of 9.0–21.9 per 10,000 births, varying by region.
Rates can be as high as 10 per 1,000 births in some African regions. A 2021 meta-analysis found a pooled African prevalence of 21.42 per 10,000 births (2.1/1,000), with hotspots in Ethiopia (61.43/10,000), Algeria (75/10,000), and Nigeria (32.77/10,000) 610. Eastern Africa had the highest burden (111.13/10,000).
Inadequate folic acid intake, limited prenatal care, and low awareness are associated with NTDs in some African regions. For instance, only 26% of Nigerian women knew the benefits of folic acid, and 37.7% used supplements. Lack of mandatory folic acid fortification in sub-Saharan Africa exacerbates the issue.
In Nigeria, the prevalence ranges from 1.5 to 10.5 per 1,000 live births. Studies reported 2.2–7.0 per 1,000 births in Nigeria. For example:
In Nigeria, low folic acid supplementation, cultural practices, and healthcare access have been identified as risk factors for NTDs. Only 1.7% of Nigerian women took folic acid in the first trimester. Poverty and low antenatal care attendance were key risk factors.
The Common Neuro Tubular Defects
1. Spina Bifida
Spina bifida is one of the most common types of neuro tubular defects. It occurs when the spinal column does not close completely, leaving a portion of the spinal cord and nerves exposed. This condition can lead to a range of physical and neurological impairments, depending on the severity and location of the defect. In mild cases, individuals may experience little to no symptoms, while more severe cases can result in paralysis, loss of sensation, and difficulties with bladder and bowel control.
The exact cause of spina bifida is not fully understood, but it is believed to result from a combination of genetic and environmental factors. Maternal folic acid deficiency is a significant risk factor for spina bifida, as adequate levels of this nutrient are essential for proper neural tube closure during early pregnancy. Research has shown that women who consume sufficient folic acid before conception and during the first trimester significantly reduce their risk of having a child with spina bifida.
2. Anencephaly
Anencephaly is a more severe form of neural tube defect characterized by the absence of a major portion of the brain, skull, and scalp. Infants born with anencephaly typically do not survive long after birth, as the condition is incompatible with life. The exact cause of anencephaly is also not fully understood, but it is believed to be influenced by genetic and environmental factors, including maternal nutrition.
Like spina bifida, anencephaly is associated with folic acid deficiency during early pregnancy. Studies have demonstrated that women who take folic acid supplements before conception and during the first trimester can significantly lower their risk of having a child with anencephaly. This highlights the critical role of folic acid in preventing neuro tubular defects and the importance of ensuring that women of childbearing age receive adequate nutrition.
3. Encephalocele
Encephalocele is another type of neural tube defect that occurs when a portion of the brain protrudes through an opening in the skull. This condition can vary in severity, with some infants experiencing significant neurological impairments while others may have milder symptoms. The exact cause of encephalocele is not well understood, but it is believed to be related to a combination of genetic and environmental factors.
Research has indicated that folic acid deficiency may also play a role in the development of encephalocele. Women who consume adequate amounts of folic acid before and during pregnancy may reduce their risk of having a child with this condition.
Implications of Neuro tubular defects
The implications of neuro tubular defects in children can be profound and far-reaching. Physically, children with NTDs may experience a range of disabilities, including mobility challenges, cognitive impairments, and difficulties with daily activities. For instance, children with spina bifida may require assistive devices, such as wheelchairs or braces, and may need ongoing medical care and therapy to manage their condition.
In addition to physical challenges, neuro tubular defects can also have significant emotional and psychological implications for affected children and their families. Children with NTDs may face social stigma, bullying, and difficulties in forming relationships with peers. The emotional toll on families can be substantial, as parents may experience stress, anxiety, and financial burdens associated with ongoing medical care and support.
Furthermore, the long-term implications of neuro tubular defects can extend into adulthood. Individuals with NTDs may face challenges in education, employment, and independent living, impacting their overall quality of life. This highlights the importance of early intervention, comprehensive care, and support for families affected by neuro tubular defects.
How to Prevent Neuro tubular Defects in Children
Preventing neuro tubular defects in children is primarily focused on ensuring adequate folic acid intake before conception and during early pregnancy. Here are several effective strategies for preventing NTDs:
1. Folic Acid Supplementation
One of the most effective ways to prevent neuro tubular defects is through folic acid supplementation. The Centers for Disease Control and Prevention (CDC) recommends that all women of childbearing age consume 400 micrograms (mcg) of folic acid daily, starting at least one month before conception and continuing through the first trimester. For women with a history of having a child with an NTD, a higher dose of 4,000 mcg may be recommended.
Folic acid supplements like Evergreen Folic Acid + B12 are widely available and can be found in various forms, including tablets, gummies, and fortified foods. It is essential for women to consult with their healthcare providers to determine the appropriate dosage and ensure they are receiving adequate folic acid.
2. Dietary Sources of Folic Acid
In addition to supplementation, consuming a diet rich in folate can help prevent neuro tubular defects. Foods high in folate include leafy green vegetables (such as spinach and kale), legumes (such as lentils and beans), citrus fruits, nuts, and fortified cereals. Encouraging a balanced diet that includes these foods can help women meet their folate needs.
3. Public Awareness Campaigns
Raising awareness about the importance of folic acid in preventing neuro tubular defects is crucial. Public health campaigns can educate women of childbearing age about the significance of adequate folic acid intake and encourage them to take supplements before and during pregnancy. Healthcare providers can play a vital role in disseminating this information during routine check-ups and preconception counseling.
4. Access to Healthcare
Improving access to healthcare services is essential for preventing neural tube defects. Women should have access to prenatal care, where healthcare providers can monitor their nutritional status and provide guidance on supplementation. Community health programs can also help reach underserved populations and ensure that all women have access to the resources they need to prevent NTDs.
Conclusion
Preventing neuro tubular defects in children is a critical public health goal that can significantly improve maternal and child health outcomes. Adequate folic acid intake before conception and during early pregnancy is essential for reducing the risk of NTDs. By promoting folic acid supplementation like Evergreen Folic Acid, encouraging a balanced diet rich in folate, and raising awareness about the importance of nutrition during pregnancy, we can work towards reducing the incidence of neural tube defects and ensuring healthier futures for children.
FAQs
1. What are neuro tubular defects?
Neuro tubular defects are congenital anomalies that occur when the neural tube fails to close completely during early fetal development, leading to conditions such as spina bifida and anencephaly.
2. How common are neuro tubular defects?
Globally, neuro tubular defects affect approximately 1 in 1,000 live births, with higher prevalence rates in certain regions, particularly in developing countries.
3. What role does folic acid play in preventing neural tube defects?
Folic acid is essential for DNA synthesis and cell division, and adequate intake before conception and during early pregnancy significantly reduces the risk of neural tube defects.
4. How much folic acid should women take to prevent neural tube defects?
The CDC recommends that women of childbearing age consume 400 micrograms of folic acid daily, starting at least one month before conception and continuing through the first trimester.
5. What foods are high in folate?
Foods rich in folate include leafy green vegetables, legumes, citrus fruits, nuts, and fortified cereals.
6. Can neuro tubular defects be detected during pregnancy?
Yes, neural tube defects can often be detected through prenatal screening methods, such as ultrasound and maternal blood tests.
7. What should I do if I have a family history of neuro tubular defects?
If you have a family history of neuro tubular defects, it is essential to consult with a healthcare provider for personalized advice on folic acid supplementation and prenatal care.
