Although taking folic acid pills three months before conception through the
first three months of pregnancy reduces the prevalence of neural tube defects in
newborns by up to 70 percent, many women of fertile age still do not take this
type of B vitamin daily.
As a result, the Health Ministry reported on
Wednesday, the number of infants born with the devastating defects has remained
stable or even been increasing.
Neural tube defects affect the brain and
spinal cord, and the two most common are spina bifida and anencephaly.
spina bifida, the fetal spinal column doesn’t close completely during the first
month of pregnancy. Nerve damage that causes at least some paralysis of the legs
usually occurs. In anencephaly, only a minority of the brain develops, causing
babies with the defect to be born dead or to die a short time after
Getting enough folic acid, a type of B vitamin, before and during
pregnancy prevents most neural tube defects. Treatments for neural tube defects
vary depending on the type of defect. Since about half of pregnancies are not
planned, it is best for all women of fertile age to take 0.4 mg of folic acid on
a daily basis.
The ministry first published in 2000 its recommendations
that fertile women take folic acid on a daily basis to drastically reduce the
risk of neural tube defects. In that year, only 5% of women in this age group
took the vitamin. Now 50% of the relevant population takes folic acid, and this
reduced neural tube defects by 30% to 50%. But in recent years, the ministry
continued, the rate of taking the pills has remained steady, and the prevalence
of defects has not declined.
As a result, the ministry instructed the
health funds and their doctors and nurses that at every meeting with women who
are younger than menopausal age, they should be reminded to take folic acid
pills – 1.5 milligrams during the three months before pregnancy on a daily –
which are included in the health basket.
The medical staffers should not
just advise women to take the pills but explain their importance and the
significance of neural tube disorders.
The daily pills should also be
taken with 30 mgs of iron, which is important from the fourth months of
pregnancy at least until six weeks after delivery, to minimize iron-deficiency
anemia in the women and their babies. The pills should be taken no matter how
much folic acid is taken naturally in the diet. Iron is best absorbed along with
vitamin C (available naturally in foods; no extra pills need be
Women should, however, consume eggs, fish and dairy products on a
regular basis so they get an adequate amount of vitamin B12, the ministry
Women at high risk for babies with neural tube defects include
those who already had a baby or fetus with such defects, couples with a family
history of such defects, and women who take the antiepileptic drugs Valproic
acid/Depakene, Carbamazapine/ Tegretol, lamotrigine, topiramate or e-phenytoin
or psychiatric drugs such as lithium or methotrexate; and women with an alcohol
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