Folic acid spina bifida

Folic acid is a coenzyme involved in the metabolism of one-carbon fragments the methyl, hydroxymethyl, and formyl groups. An inadequate intake of folic acid during pregnancy can result in spina bifida. 

Folic acid (vitamin Bg) is a conjugate of a pteridine unit, p-aminobenzoic acid, and glutamic acid. Deficiency of folic acid leads to anaemia, and it is also standard practice to provide supplementation during pregnancy to reduce the incidence of spina bifida. 

Centers for Disease Control and Prevention (CDC). Spina bifida and anencephaly before and after folic acid mandate-United States, 1995-1996 and 1999-2000. Morb Mort Wkl Rep 2004 53(17) 362-5. 

Folic acid supplements are given to pregnant women to decrease the risk of neural tube defects such as spina bifida. Prenatal vitamin preparations that contain higher concentrations of folic acid must be dispensed under a health care worker s guidance because high folate intakes can mask the symptoms of pernicious anemia. 

Folic acid deficiency, unlike vitamin B12 deficiency, is often caused by inadequate dietary intake of folates. Patients with alcohol dependence and patients with liver disease can develop folic acid deficiency because of poor diet and diminished hepatic storage of folates. Pregnant women and patients with hemolytic anemia have increased folate requirements and may become folic acid-deficient, especially if their diets are marginal. Evidence implicates maternal folic acid deficiency in the occurrence of fetal neural tube defects, eg, spina bifida. (See Folic Acid Supplementation A Public Health Dilemma.) Patients with malabsorption syndromes also frequently develop folic acid deficiency. Patients who require renal dialysis develop folic acid deficiency because folates are removed from the plasma during the dialysis procedure. 

It s never too early to start taking a prenatal vitamin when attempting to conceive. If one makes you feel nauseated, keep trying others, as there is a large variety on the market. But be absolutely sure to take one that includes the maximum daily recommended dose of folic acid (important for helping prevent neural tube defects and spina bifida). Organic prenatal vitamins do exist. The main differences between these and more conventional vitamins is that they re vegetarian and include no filler, artificial color, or flavor. 

Q12 Yes, valproate increases the risk of giving birth to a baby with spina bifida or anencephaly since valproate antagonizes the effects of folic acid and causes these neural tube defects. Thus women who suffer from epilepsy and who are taking valproate should receive a much higher dosage of folic acid (5 mg daily) compared to healthy women, who are advised to take 400 J.g daily. 

Prevention of fetal neural tube defect (spina bifida). Folic acid supplementation taken before conception and during the early weeks of pregnancy has been shown in an 8-year trial to prevent the condition in pregnancies subsequent to an affected birth. Women hoping to conceive and who have had an affected child are advised to take folic acid 5 mg/day. To prevent a first occurrence 400 micrograms/day should be taken both before conception, or as soon as possible after diagnosis. In both cases folate supplement should be taken for the first 12 weeks of pregnancy. 

Folic acid can prevent at least some children from being bom with spina bifida or other birth defects. 

Neural tube defects, characterized by a failure of the neural tube to close properly after conception, affect about one in 1000 live births in the USA. Periconceptional folic acid supplementation reduces the risk. To determine whether periconceptional exposure to folic acid antagonists might therefore increase the risk of neural tube defects, data from a case-control study of birth defects (1979-98) in the USA and Canada have been examined (14). Data on 1242 infants with neural tube defects (spina bifida, anencephaly, and encephalo-cele) were compared with data from a control group of 6660 infants with malformations not related to vitamin supplementation. Triamterene is a folic acid antagonist and in this series was associated with the development of neural tube defects, but there were too few cases to estimate an odds ratio. 

Folic acid is a vitamin (sometimes called vitamin M or vitamin Be) found naturally in mushrooms, spinach, and yeast. It is an important dietary supplement during pregnancy, as it reduces the likelihood of spina bifida. U.S. 5,968,788 (to Toray Industries) describes conditions for cultivating several strains of yeast or bacteria to increase their yield of folic acid, and gives yields for each species. Determine the optimum strain and recovery process to make a USE product and estimate the cost of production via this route. 

In 1992, the results of a landmark study by Czeizel A and Dudas I were published in the New England Journal of Medicine. Using a carefully controlled double-blind protocol (considered the gold standard by which clinical trials of new pharmaceuticals are routinely conducted), these investigators found that 0.8 mg day of folic acid (a water-soluble B vitamin) in a multivitamin preparation prevented spina bifida and anencephalus in the Hungarian women in their study. A subsequent study by Werler M and associates of Boston University (published in... 

High doses of folic acid can mask signs of B12 deficiency, which is a risk in elderly people. Patients taking phenytoin (Dilantin) for seizures should be cautious about taking folic acid because it can increase the risk of seizures. During the first trimester of pregnancy, folic acid deficiency can affect the development of the central nervous system (CNS) of the fetus this can lead to neural tube defects (NTDs) such as spina bifida, a defective closure of the bony structure of the spinal cord, or anencephaly, lack of brain mass formation... 

Centers for Disease Control and Prevention. Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects. MMWR 1992 41(RR14) l-7. 

Folic Acid Deficiency Promotes Birth Defects Such As Spina Bifida... 

Spina bifida is one of a class of birth defects characterized by the incomplete or incorrect formation of the neural tube early in development. In the United States, the prevalence of neural-tube defects is approximately 1 case per 1000 births. A variety of studies have demonstrated that prevalence of neural-tube defects is reduced by as much as 70% when women take folic acid as a dietary supplement before and during the first trimester of pregnancy. One hypothesis is that more folate derivatives are needed for the synthesis of DNA precursors when cell division is frequent and substantial amounts of DNA must be synthesized. 

The answer is a. (Murray, pp 812-828. Scriver, pp 3-45. Sack, pp 167-180. Wilson, pp 287-324.) Spina bifida is a defect of neural tube development that can be partially prevented by encouraging preconceptional folic acid supplementation in women desiring to become pregnant. Examination for subtle evidence of dysmorphology in children with major birth defects is necessary to rule out a syndrome. Syndromes often exhibit Mendelian or chromosomal inheritance. 

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