Neural Tube Defects
Neural tube defects (also called NTDs) are birth defects of the brain and spinal cord. Birth defects are health conditions that are present at birth. They change the shape or function of one or more parts of the body. Birth defects can cause problems in overall health, how the body develops or how the body works.
A baby’s neural tube normally starts out as a tiny, flat ribbon that turns into a tube by the end of the first month of pregnancy. If the tube doesn’t close completely, an NTD can happen. NTDs can cause serious problems for babies, including death.
The chance that a pregnancy will be affected by a neural tube defect is less than one in 1,000.
The two most common NTDs are spina bifida and anencephaly.
• Spina bifida
If your baby has spina bifida, the tiny bones of the spine don’t close completely, and part of the spinal cord pokes through the spine. Children with spina bifida may have paralyzed legs (not able to move) and problems controlling their bladder and bowel (going to the bathroom). Milder forms of spina bifida may cause fewer problems for children.
It is one of the most severe NTDs. Anencephaly is caused when the upper part of the neural tube that forms the brain doesn’t close completely. Babies with this condition are missing major parts of the brain, skull and scalp. They do not survive long after birth, usually for just a few hours. Girls are 3 times more likely than boys to have anencephaly.
The exact cause of NTDs is not known. It may be difficult to determine because the defects begin in the first month of pregnancy. A lot of women don’t even know they are pregnant at this stage.
Your risk for having a baby with neural tube defects increases if you:
• Have a family history of NTDs.
• Are obese.
• Have diabetes.
• Take certain medicines to prevent seizures.
• Are of a certain race. NTDs are highest among Hispanics.
Other potential risk factors are genetics and the environment.
Neural tube defects may be diagnosed during the ultrasound scan that is carried out around week 12 of the pregnancy or, more likely, during the anomaly scan that is carried out at around weeks 18 to 20.
There is no cure for neural tube defects.
• Spina Bifida
Treatment depends on the type and severity of spina bifida. Most children with mild form of the disorder need no treatment, although some may require surgery as they grow. This prevents further damage to the nervous tissues and protects them against infections. The spinal cord and its nerve roots are put back into the spine and sealed up.
Some children with spina bifida need assistive devices (like braces, crutches, or wheelchairs) depending on the location of the malformation in the spine.
There is no cure for children with anencephaly. Children born with this condition are usually stillborn or die shortly after birth.
About 2 in 3 neural tube defects can be prevented through increasing folate (folic acid) intake at least a month before pregnancy and during the first 3 months of pregnancy. Adequate folate levels are critical during the early days of the developing embryo, particularly the 3rd and 4th week, the period in which neural tube defects occur and when many women won’t know they are pregnant.
You can increase your folate intake by eating folate-rich foods, including folate-fortified foods in your daily diet, or by taking a folic acid supplement.
Foods high in folate includes:
• dark green leafy vegetables (such as spinach)
• oranges and orange juice
Women who take medicines to control epilepsy, seizures or psychiatric disorders should talk to their doctor before taking folate because it can interfere with how their medications work.
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