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Risk factors
By Mayo Clinic staffAlthough doctors and researchers don't know for sure why spina bifida occurs, they have identified a few risk factors:
- Race. Spina bifida is more common among whites and Hispanics.
- Family history of neural tube defects. Couples who've had one child with a neural tube defect have a slightly higher chance of having another baby with the same defect. That risk increases if two previous children have been affected by the condition. In addition, a woman who was born with a neural tube defect, or who has a close relative with one, has a greater chance of giving birth to a child with spina bifida. However, most babies with spina bifida are born to parents with no known family history of the condition.
- Folate deficiency. Folate (vitamin B-9) is important to the healthy development of a fetus. Folate is the natural form of vitamin B-9. The synthetic form, found in supplements and fortified foods, is called folic acid. A folate deficiency increases the risk of spina bifida and other neural tube defects.
- Some medications. Anti-seizure medications, such as valproic acid (Depakene), seem to cause neural tube defects when taken during pregnancy, perhaps because they interfere with the body's ability to use folate and folic acid.
- Diabetes. Women with diabetes who don't control their blood sugar well have a higher risk of having a baby with spina bifida.
- Obesity. Pre-pregnancy obesity is associated with an increased risk of neural tube birth defects, including spina bifida.
- Increased body temperature. Some evidence suggests that increased body temperature (hyperthermia) in the early months of pregnancy may increase the risk of spina bifida. Elevating your core body temperature by about 3 to 4 degrees Fahrenheit above normal — about 2 degrees Celsius — due to fever or the use of saunas, hot tubs or tanning beds, has been associated with increased risk of spina bifida.
If you have known risk factors for spina bifida, talk with your doctor to determine if you need a larger dose or prescription dose of folic acid, even before a pregnancy begins. If you take medications, tell your doctor. Some medications can be adjusted to diminish the potential risk of spina bifida, if plans are made ahead of time.
References
- Spina bifida fact sheet. National Institute of Neurological Disorders. http://www.ninds.nih.gov/disorders/spina_bifida/detail_spina_bifida.htm. Accessed July 30, 2009.
- Spina bifida. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec19/ch292/ch292c.html. Accessed July 30, 2009.
- Spina bifida, March of Dimes. http://www.marchofdimes.com/pnhec/4439_1224.asp. Accessed July 30, 2009.
- Hochberg L. Prenatal screening and diagnosis of neural tube defects. http://www.uptodate.com/index/home.html. Accessed July 30, 2009.
- Ask the doctor archive. Spina Bifida Association. http://www.spinabifidaassociation.org/site/c.liKWL7PLLrF/b.2738091/k.9A71/Risk_Factor.htm. Accessed Aug. 1, 2009.
- Cameron M, et al. Prenatal screening and diagnosis of neural tube defects. Prenatal Diagnosis. 2009;29:402.
- Routine tests in pregnancy. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp133.cfm. Accessed Aug. 1, 2009.
- FAQs about folic acid. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/folicacid/faqs.html. Accessed July 30, 2009.
- Edwards MJ. Hyperthermia and fever during pregnancy. Birth Defects Research (Part A): Clinical and Molecular Teratology. 2006;76:507.
- Folic acid for the prevention of neural tube defects: U.S. Preventive Services Task Force recommendation statement. Rockville, Md.: U.S. Preventive Services Task Force. http://www.annals.org/cgi/reprint/150/9/626.pdf. Accessed Aug. 24, 2009.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 24, 2009.
