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Prevention
By Mayo Clinic staffFolic acid, taken in supplement form at least one month before conception and during the first trimester of pregnancy, greatly reduces the risk of spina bifida and other neural tube defects.
Get folic acid first
It's critical to have enough folic acid in your system by the early weeks of pregnancy to prevent spina bifida. Because many women don't discover that they're pregnant until this time, experts recommend that all women of childbearing age take a daily supplement with between 400 and 800 micrograms (mcg) of folic acid. Several foods, including breakfast cereals, are fortified with 400 mcg of folic acid per serving. Folic acid may be listed on food packages as folate, which is the natural form of folic acid found in food.
Planning pregnancy
If you're actively trying to conceive, most pregnancy experts believe supplementation of at least 400 mcg of folic acid a day is the best approach for women planning pregnancy. Your body doesn't absorb folate as easily as it absorbs synthetic folic acid, and most people don't get the recommended amount of folate through diet alone, so vitamin supplements are necessary to prevent spina bifida. And, it's possible that folic acid will also help reduce the risk of other birth defects, including cleft lip, cleft palate and some congenital heart defects.
It's also a good idea to eat a healthy diet, including foods rich in folate or enriched with folic acid. This vitamin is present naturally in many foods, including:
- Beans
- Citrus fruits
- Egg yolks
- Dark green vegetables, such as broccoli and spinach
When higher doses are needed
If you have spina bifida or if you've given birth to a child with spina bifida, you'll need extra folic acid before you become pregnant. If you're taking anti-seizure medications or you have diabetes, you may also benefit from a higher dose of this B vitamin. In these cases, the recommended dose of folic acid may be up to 4,000 mcg (4 mg) beginning one month prior to conception and during the first few months of pregnancy. However, check with your doctor before taking additional folic acid supplements.
- 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.
