In 1980 the Spanish Collaborative Study of Congenital Malformations began collecting data about Spanish babies born with birth defects. In these years, so far, the percentage of newborns with these characteristics has dropped from 2.2% to 0.96%. This decline has been especially pronounced in the case of spina bifida, whose incidence has fallen from 4.73 cases per thousand births to 0.48 cases.
Behind these numbers is the awareness that has been carried out by the health authorities so that Women take folic acid to prevent neural tube defects.
In the first weeks of pregnancy
Some of the baby’s most important structures are formed in the very first weeks of pregnancy. This is the case of the neural tube, which closes approximately in the sixth week of gestation. The neural tube is what will give rise to the central nervous system, that is, the brain and spinal cord, making it a key organ. To prevent neural tube defects, folic acid is essential. Thus, when a woman has adequate reserves of this vitamin, the risk of anencephaly and spina bifida is considerably reduced. Anencephaly causes the baby to be born without parts of the brain, while in spina bifida it is the spine and spinal cord that do not form well.
What is the problem? That when the neural tube closes, many women do not even know that they are pregnant yet. Therefore, the recommendation is start taking folic acid three months before attempting pregnancy. “In the universe of vitamins and supplements, folic acid shines with its own light. This compound has proven to be the indispensable tool in the prevention of congenital neural tube defects in babies, with an effectiveness that no other form of folate can claim,” stressed Dr. Javier Ruiz Labarta, specialist in Gynecology and Obstetrics at the Hospital University student Gregorio Marañón from Madrid and speaker at the Debate “The importance of folic acid during pregnancy.”
Globally, an estimated eight million children are born with neural tube defects. In some cases, these babies have a high mortality rate in the first year of life. Those who succeed often have to face great physical and neurocognitive difficulties.
© Adobe StockHow much folic acid should you take?
Except in specific cases, which must be evaluated by the gynecologist, The general recommendation is to take 400 micrograms of folic acid each day, in addition to a diet rich in folates. Folic acid is a B vitamin, specifically vitamin B9. When taken in excess, it is eliminated through urine, so the advice is to do a daily and uninterrupted intake so as not to eliminate that protective effect. In fact, in some countries certain commonly consumed foods are enriched with folic acid to ensure adequate levels in the female population of reproductive age.
When we talk about folates present in foods, we must take into account that they are unstable to oxidation, heat and light, so the amount that reaches women may be clearly insufficient. In fact, cooking vegetables can destroy up to 50-80% of their folates. For this reason, The only way for a woman who is planning a pregnancy or who is already pregnant to meet the requirements of this nutrient is to take a pharmacological supplement. These medications are formulated to be more stable and more easily absorbed by the body, that is, they have greater bioavailability.
Folic acid has proven to be the indispensable tool in the prevention of neural tube birth defects in babies, with an effectiveness that no other form of folate can claim.
In addition to having a direct impact on neural tube defects, folic acid also impacts other procedures of great importance and protects the baby in more ways. “We know that folic acid also intervenes in the processes of global DNA methylation, its maintenance and repair, having an overall beneficial effect on prematurity, low birth weight, hypertension in pregnancy, maternal and childhood obesity and insulin resistance, as well as childhood neurocognitive development,” highlighted María Jesús Domínguez, advisor to the Federation of Midwives Associations of Spain and the Association of Midwives of Madrid, and participant in said debate. In fact, their recommendation is to “maintain folic acid supplementation during the rest of pregnancy and breastfeeding.”
