Ministry: Younger women should take folic acid daily

Taking pills prior to, and at beginning of pregnancy reduces the prevalence of spina bifida and anencephaly in newborns.

By JUDY SIEGEL-ITZKOVICH
Pregnant woman does yoga in New York 370 (R) (photo credit: Shannon Stapleton / Reuters)
Pregnant woman does yoga in New York 370 (R)
(photo credit: Shannon Stapleton / Reuters)
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.
In 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 birth.
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 taken).
Women should, however, consume eggs, fish and dairy products on a regular basis so they get an adequate amount of vitamin B12, the ministry advised.
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 abuse problem.