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Surge in spina bifida prompts folic acid call

A sudden rise in spina bifida cases in Scotland and in parts of England and Wales has prompted calls for all women of child-bearing age to take folic acid supplements.

Fifteen Scottish babies have been born with the condition this year, around twice the normal number, according to the Scottish Spina Bifida Association (SSBA ).

“This year we’ve had as many contacts from families in the first half of the year as we’d expect to see for the full year,” said Dr Margo Whiteford, the SSBA chairman.

“We don’t know if this is down to folic acid but we do know that most women don’t take enough folic acid at the right time.

“Ladies do know about folic acid preventing spina bifida, but they wait until they’ve missed a period before they start taking it.”

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There is some evidence that there may have been a similar rise in spina bifida cases in England and Wales, although no national figures are currently available. Jackie Bland, the chief executive Association for Spina Bifida and Hydrocephalus (Asbah ), confirmed that in some areas there were indications that there may be a similar increase.

“Although we are not notified about all births certainly in our Northern Region and possibly in the Midlands we have noticed pockets of higher incidence,” said Mrs Bland.

“At present we do not know why some regions are showing an upward trend. But we do know that improved scanning technology and better knowledge about the lives that people with spina bifida can live means that parents have more evidence on which to base a decision. “

Spina bifida is a condition in which vertebrae in the backbone form incorrectly, often leading to paralysis from the waist down and other damage to the nervous system.

Folic acid supplements are believed to help prevent spina bifida, but the substance is only effective straight after conception.

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“The spinal cord develops within the first four weeks of pregnancy so by that stage it’s too late - if the baby’s going to have spina bifida it will already have developed it,” Dr Whiteford told the BBC.

Mrs Bland endorsed Dr Whiteford’s message that all woman who might fall pregnant should be taking folic acid supplements, and urged any parents whose unborn child was diagnosed with the condition to contact Asbah’s helpline for information and advice.

The Food Standards Agency currently recommends pregnant women take a daily 400 micrograms folic acid supplement until the 12th week of pregnancy, as well as eating foods containing the natural form of folic acid such as green vegetables, brown rice, and breakfast cereals.

Currently, it is not mandatory in the UK to add the vitamin to food, although experts are assessing the evidence to make a decision.

The FSA has recommended that the acid should be added to flour. Mandatory fortification of flour with folic acid was introduced in America and Canada a decade ago, while Chile followed suit in 2000.